Atypical form of cat scratch disease in immunocompetent patient

Abstract

Introduction. Cat scratch disease (CSD) is an acute infectious disease with benign course caused by the bacteria Bartonella henselae. Clinically, it is usually manifested as regional lymphadenopathy and mild infective syndrome. Rare forms of the disease which usually occur in immunocompromised presons are: encephalitis, transverse myelitis, neuroretinitis, granulomatosus conjunctivitis, arthritis, hepatitis etc. Case report. We presented an atypical form of cat scratch disease in a young immunocompetent female person. The disease was manifested with prolonged fever, rash, purulent lymphadenitis and hepatitis. The diagnosis was based on characteristic patohystological finding and exclusion of the other causes of lymphadenopathy. The patient was treated by antibiotics for a few weeks, with surgical incision and drainage of the purulent lymphadenitis. Conclusion. Atypical forms of CSD could be an important differential-diagnostic problem, especially if there is no opportunity for serological confirmation of the disease.Uvod. Bolest macjeg ogreba (BMO) je akutno infektivno oboljenje benignog toka ciji je izazivac bakterija Bartonella henselae. Klinicki, najcesce se ispoljava kao regionalna limfadenopatija uz blag infektivni sindrom. U retke forme bolesti, koje se obicno javljaju kod imunokompromitovanih, spadaju encefalitis, transverzalni mijelitis, neuroretinitis, granulomatozni konjunktivitis, artritis, hepatitis i druge. Prikaz bolesnika. U radu je prikazan atipican oblik BMO kod mlade imunokompetentne osobe zenskog pola. Bolest se ispoljila produzenom febrilnoscu, ospom, gnojnim limfadenitisom i hepatitisom. Definitivna dijagnoza je postavljena na osnovu karakteristicnog patohistoloskog nalaza i iskljucivanjem drugih uzrocnika gnojnog limfadenitisa. Lecenje je sprovedeno visenedeljnom primenom antibiotika uz hirursku inciziju i drenazu gnojnog limfadenitisa. Zakljucak. Atipicne forme BMO mogu predstavljati znacajan diferencijalno-dijagnosticki i terapijski problem, posebno kada nema mogucnosti za serolosku potvrdu bolesti.