INFECTION BY BARTONELLA-HENSELAE IN IMMUN OCOMPETENT PATIENTS - CAT-SCRATCH DISEASE

Background: Cat scratch disease, whose etiologic agent is Bartonella b enselae, is a benign disease in immunocompetent subjects, characterize d by lymphadenopathy of prolonged course and occasional involvement of other organs such as liver, spleen, central nervous system, eye and l ung. In immunocompromised patients, the infection is bacteremic and di sseminated. Aims: To report Chilean cases of cat scratch disease. Pati ents and methods: Ten children (seven male, aged between 6 and 13 year s old) with histologically or serologically confirmed cat scratch dise ase are reported. Results: Lymphadenopathy location was pre auricular in four cases, axillary in two, inguinal in two and epitrochlear in tw o. Three children had fever over 39 degrees C and two had a Parinaud s yndrome. Nine children had a history of cat scratch and one of a cat b yte. Six had an erythrocyte sedimentation rate over 40. Lymph node ult rasound examination was a useful diagnostic tool. Two patients had spl enic granulomas. Lymph node biopsies were obtained in four cases, show ing a suppurative granulomatous lymphadenitis in all and a positive Wa rtbin-Starry stain in two. Serology, done in patients without histolog ical confirmation was positive with titles ranging from 1:64 to 1:8192 . All patients had a satisfactory outcome with regression of lymphaden opathy. Conclusions: Infections by Bartonella hemselae occur in the Ch ilean population and must be considered in the differential diagnosis of regional lymph node enlargement.