Talks
Presentation Type
Oral Presentation
Discipline Track
Patient Care
Abstract Type
Case Report
Abstract
Cat scratch disease (CSD) is caused by the bacterium Bartonella henselae, typically characterized by self-limiting regional lymphadenopathy. CSD is more prevalent in immunocompromised individuals. However, serious illness is infrequent. This case report demonstrates uncommon symptoms of disseminated Bartonella henselae infection manifesting as encephalopathy, thrombocytopenia, and septic shock.
A 62-year-old malnourished, Hispanic man presented with fever and malaise for 1 week which was associated with headache. Past medical history was significant for rheumatoid arthritis treated with prolonged, unmonitored prednisone, chronic obstructive pulmonary disease, and a history of 18 cats at home. On examination, the patient was alert and oriented, febrile, and cachectic, but no regional lymphadenopathy was appreciated. During the hospital course, the patient became more agitated and required intubation. Serological tests showed negative IgM but very high IgG titers of 1:1280 which is indicative of CSD. CSF analysis demonstrates pleocytosis with negative bacterial and fungal culture. The patient was treated with doxycycline for CSD and with voriconazole for concomitant scant growth of Aspergillus flavus on sputum culture. Subsequently, the patient improved with no residual neurological deficits.
This case illustrates the importance of investigating Bartonella henselae infection despite the absence of regional lymphadenopathy in an immunosuppressed patient with a history of cat exposure presenting with persistent fever. Neurological symptoms are uncommon but can occur especially with immunosuppression. Moreover, obtaining a history of animal exposure prior to initiating immunosuppressive medications is pertinent.
Academic/Professional Position
Resident
Recommended Citation
Rajan, Celin; Mendez, Ileana; Kadour, Jacinto; Jamal, Mohammed; and Najam, Maria, "Disseminated infection with Bartonella henselae in a drug-induced immunosuppressed adult causing fever, thrombocytopenia, and encephalitis: Case Report" (2023). Research Symposium. 4.
https://scholarworks.utrgv.edu/somrs/2022/talks/4
Included in
Disseminated infection with Bartonella henselae in a drug-induced immunosuppressed adult causing fever, thrombocytopenia, and encephalitis: Case Report
Cat scratch disease (CSD) is caused by the bacterium Bartonella henselae, typically characterized by self-limiting regional lymphadenopathy. CSD is more prevalent in immunocompromised individuals. However, serious illness is infrequent. This case report demonstrates uncommon symptoms of disseminated Bartonella henselae infection manifesting as encephalopathy, thrombocytopenia, and septic shock.
A 62-year-old malnourished, Hispanic man presented with fever and malaise for 1 week which was associated with headache. Past medical history was significant for rheumatoid arthritis treated with prolonged, unmonitored prednisone, chronic obstructive pulmonary disease, and a history of 18 cats at home. On examination, the patient was alert and oriented, febrile, and cachectic, but no regional lymphadenopathy was appreciated. During the hospital course, the patient became more agitated and required intubation. Serological tests showed negative IgM but very high IgG titers of 1:1280 which is indicative of CSD. CSF analysis demonstrates pleocytosis with negative bacterial and fungal culture. The patient was treated with doxycycline for CSD and with voriconazole for concomitant scant growth of Aspergillus flavus on sputum culture. Subsequently, the patient improved with no residual neurological deficits.
This case illustrates the importance of investigating Bartonella henselae infection despite the absence of regional lymphadenopathy in an immunosuppressed patient with a history of cat exposure presenting with persistent fever. Neurological symptoms are uncommon but can occur especially with immunosuppression. Moreover, obtaining a history of animal exposure prior to initiating immunosuppressive medications is pertinent.