CAT-SCRATCH DISEASE CAUSED BY BARTONELLA-HENSELAE - THE FIRST CASE-REPORT IN TAIWAN

We report a typical case of cat-scratch disease caused by Bartonella h enselae, in Taiwan. A 20-year-old man developed right axillary lymphad enopathy 2 weeks after being scratched on his right hand by a kitten. The axillary lymphadenopathy resolved gradually and spontaneously afte r 10 weeks without specific treatment. Serologic tests were not done d uring the acute stage of the event. However, an immunofluorescent anti body test performed during the convalescent stage was positive for B. henselae antibodies, and the concentration dropped by fourfold 2 month s later. Histopathologic examination of a biopsy specimen from tl:le r ight axillary lymph node revealed findings characteristic of cat-scrat ch disease including multiple foci of microabscesses surrounded by his tiocytes and infiltration by plasma cells and lymphocytes. This is the first reported case of cat-scratch disease in Taiwan, with a history of contact with a cat, a positive serologic test for B. henselae infec tion and characteristic histopathologic findings of cat-scratch diseas e which met the criteria for diagnosis.