Cat-scratch disease causing status epilepticus in children

Status epilepticus from cat-scratch encephalopathy is often recalcitrant to usual therapies, causing treatment to focus on critical care management of the patient that may require aggressive interventions, such as continuous pentobarbital administration, We describe two children whose initial clinic al presentation of cat-scratch disease was status epilepticus with normal c erebrospinal fluid studies. A history of cat exposure (specifically, kitten and/or fleas), regional lymphadenopathy, and a papule or inoculation site should be sought, but are not essential for diagnosis, The presumptive diag nosis of cat-scratch disease can be made by serology alone even in the abse nce of classic diagnostic criteria. Our two cases and other reports in the literature show a favorable prognosis in most cases, despite the occurrence of status epilepticus, The diagnosis of cat-scratch disease should be stro ngly considered in all children with unexplained status epilepticus or ence phalopathy and serologic testing for Bartonella henselae should be done.