CAT-SCRATCH DISEASE WITH BARTONELLA-HENSE LAE

Bartonella henselae is an etiologic agent of cat-scratch disease and, in immunocompromised patients, of bacillary angiomatosis and other sev ere syndromes. Cat-scratch disease usually presents as lymphadenopathy , which resolves spontaneously within 2-4 months. The utility of antib iotic therapy remains controversial. In Tyrol four cases of human cat- scratch disease were diagnosed in children in 1994, yielding a prevale nce of 0.7/100 000 per year. A 3-year-old boy had lymphadenitis colli since one year despite antituberculosis therapy which was initiated be cause of the histopathological picture and a positive tuberculin react ion (despite negative mycobacteria-cultures and -PCR). Two girls, age 9 and 13 years, had lymphadenitis at upper or lower extremities after cat-scratches from kiddens. A 13-year-old boy presented with febrile i llness and right hip pain, computer tomography revealed an osteolytic lesion; symptoms subsided within 3 weeks. Diagnosis of cat-scratch dis ease is based on cat contact, negative studies for other similar disea ses, characteristic histopathologic features (if available), and resul ts of an indirect immunofluorescence test (antigen: Houston-1 isolate, ATCC 49882). We believe that the availability of this serological tes t will increase the number of diagnosed cases of human Bartonella hens elae infections.