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Cat scratch disease in a child
1Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.
Insights
This case study details a 9-year-old girl diagnosed with Cat Scratch Disease (CSD) after a kitten scratch. Prompt treatment with gentamicin effectively resolved her symptoms, highlighting the importance of timely diagnosis and intervention for CSD.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Cat Scratch Disease (CSD) is a bacterial infection transmitted by cats, primarily kittens.
- Bartonella henselae is the main causative agent of CSD, leading to characteristic symptoms.
Observation:
- A 9-year-old girl presented with cervical lymphadenopathy, fever, and malaise three weeks after a kitten scratch.
- Clinical signs included a pustula at the scratch site and conjunctivitis, meeting diagnostic criteria for CSD.
- Initial treatment by a physician was ineffective, with symptoms persisting for a week.
Findings:
- Laboratory tests revealed leukocytosis and an elevated erythrocyte sedimentation rate.
- Indirect fluorescent antibody (IFA) testing confirmed a high serum IgG titer (1:256) to Bartonella henselae.
- Intravenous gentamicin therapy resulted in rapid fever resolution within 24 hours.
Implications:
- This case underscores the importance of recognizing CSD symptoms in pediatric patients.
- Effective treatment with gentamicin led to a full clinical recovery, demonstrating its therapeutic value.
- Early diagnosis and appropriate antibiotic management are crucial for favorable outcomes in CSD cases.
Abstract:
We report a case of a 9-year-old girl scratched on the right side of her neck by a kitten about one month prior to admission. She was well until three weeks later when she developed enlarged right neck masses, a pustula on the scratch site, right injected conjunctiva, headache, general malaise and fever, thus fulfilling the clinical criteria for CSD. Initially, she was treated by a practicing physician but the manifestations persisted for one week. After admission, leukocytosis and a mildly elevated erythrocyte sedimentary rate were noted. The serum IgG titer to Bartonella henselae was performed by means of indirect fluorescent antibody (IFA) test at the National Institute of Preventive Medicine. The serum titer of anti-B, henselae Ig G was 1:256 and greater (> or = 1:256). The positive serum titer(negative titer being < 1:64) to B, henselae, the organism thought to be responsible for CSD, also supports this diagnosis. She was treated with a 7-day course of intravenous gentamicin and the fever subsided within 24 hours. Following this, she improved clinically and was discharged one week later. One month after discharge, she remained well with no palpable neck masses.