A Case of Cat Scratch Disease

Abstract

Cat scratch disease (CSD) which is usually seen in children and young adults and characterized by self limited lymphadenopathy, is caused by Bartonella henselae. In this report, a 30 years old male patient who was admitted to the outpatient clinic with the complaint of lymphadenopathy, was presented. Erythrocyte sedimentation rate and C reactive protein values of the patient were normal, and anti-HIV, Brucella agglutination and anti-toxoplasma IgM and IgG tests were negative. No bacterial growth was detected in the cultures of repetetive blood samples and biopsy specimens taken from the right axillar lymph node. This might probably be due to the prior antibiotic therapy (ciprofloxacin and cefazolin) given by another health center. Polymerase chain reaction performed with biopsy specimen by using 27f and 1525r primers, also yielded negative result. CSD was diagnosed depending on the history of direct contact with a cat (being scratched and bitten), together with the clinical features and histopathologic findings (necrotizing granulomatous inflammation concordant with CSD). Lymphadenopathies of patient had completely resolved after five-days oral azithromycin therapy. Since CSD is a rare infection of adults, it should be taken into consideration in the patients who suffer from silent lymphadenopathy and present with the history of direct contact with cats.