1953), a clinical microbiology technologist at University of Oklahoma Health Sciences Center, who collected numerous strains and samples of the infective agent during an outbreak in Oklahoma in 1985. The specific name henselae honors Diane Marie Hensel (b. The presence of bacteria can be detected by Warthin-Starry stain, or by a similar silver stain technique performed on infected tissue. It can be cultured in a lysis-centrifugation blood culture. Diagnosis īartonella henselae is a Gram-negative rod. Most often, it is transmitted from kittens. In the United States, about 22,000 people(per year?)are diagnosed, most under the age of 20. It infects the host cell by sticking to it using trimeric autotransporter adhesins. One study showed it invaded the mature blood cells of humans. It is a facultative intracellular microbe that targets red blood cells. 1993īartonella henselae, formerly Rochalimæa henselae, is a bacterium that is the causative agent of cat-scratch disease ( bartonellosis).īartonella henselae is a member of the genus Bartonella, one of the most common types of bacteria in the world. However, status epilepticus has been reported.Ī myriad of musculoskeletal complaints has been associated with cat scratch disease, including arthralgias, myalgias, and frank arthritis.(Regnery et al. Children typically present with encephalitis or aseptic meningitis. Neurologic complications of cat scratch include ataxia, cranial nerve palsies, and a dementia-like picture in older patients. Cat scratch may also cause focal or multifocal retinochoroiditis, panuveitis, branch retinal artery, and vein occlusion, leading to retinal detachment. The conjunctival infection resolves in several weeks, but the lymphadenopathy may persist for months. There is local adenopathy, typically preauricular, upper cervical, or submandibular, with severe conjunctival infection. This is an atypical presentation found in 2% to 8% percent of children, which involves an inoculation site in the conjunctiva. Ophthalmic complications include neuroretinitis, papillitis, optic neuritis, and most commonly Parinaud Oculoglandular syndrome. Cat scratch disease may be the cause of up to one-third of children with fever of unknown origin. There may be elevated acute phase reactants and liver function tests. Visceral organ involvement may include the liver, spleen, or both and present with fever, weight loss, and abdominal pain. The lymphadenopathy may last from 1 to 4 months. Common sites are the axillary, epitrochlear, cervical, supraclavicular, or submandibular lymph nodes. The lymph nodes are enlarged proximal to the inoculation site. Lymphatic system involvement presents as tender lymphadenopathy, regional, and may be solitary or multiple nodes 1 to 5 cm in diameter. Examination of intertriginous areas, other skin creases as well as the scalp may help demonstrate the primary lesion. The primary inoculation site may be a mucous membrane such as the conjunctiva that heals without scarring and is not detected. This lesion usually persists from one to three weeks but can last for months. More uncommonly, there may be ocular and neurologic involvement.Ĭutaneous manifestations begin as an erythematous papule, vesicle, or nodule, which is known as the primary inoculation lesion. Involved systems may include the cutaneous, lymphatic, and visceral organs. Patients with disseminated illness may have a spectrum of complications, especially in the very young, elderly, and immunocompromised hosts such as transplant or patients with HIV. Eighty-five percent to 90% of children have self-limited lymphadenopathy accompanied by high fever.
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