trimethoprim--sulfamethoxazole-drug-combination and Cat-Scratch-Disease

Topics: Adult; Bartonella henselae; Biopsy, Needle; Cat-Scratch Disease; Humans; Immunohistochemistry; Male; Prednisone; Prognosis; Risk Assessment; Sarcoidosis; Sweet Syndrome; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Background Appropriate antibiotic treatment of cat scratch disease (CSD) in pediatrics is not well established. Objective The purpose of this study was to evaluate the response rates of antibiotic therapy in pediatrics with CSD. Methods The electronic medical records of a cohort of pediatric patients with confirmed diagnosis of CSD (2006-2016) were reviewed, retrospectively. Data collection included patient demographics, clinical and laboratory results, antibiotic treatment and follow-up evaluations. Results One hundred and seventy-five patients (aged 7.4 ± 4.4 years) had confirmed CSD. Azithromycin and trimethoprim/sulfamethoxazole (TMP/SMX) were the largest groups with documented effectiveness at follow-up visits. Resolution and improvement of CSD was observed in 51.4% and 61.5% of patients with azithromycin and TMP/SMX, respectively among those with follow-up assessment. The effectiveness of azithromycin and TMP/SMX was comparable (p = 0.56). Conclusion Azithromycin and TMP/SMX were most frequently prescribed antibiotics. Azithromycin appeared to be an appropriate option for the treatment of CSD. TMP/SMX may be considered as an alternative antibiotic when azithromycin cannot be used.

Topics: Anti-Bacterial Agents; Azithromycin; Cat-Scratch Disease; Child; Child, Preschool; Cohort Studies; Electronic Health Records; Female; Follow-Up Studies; Humans; Infant; Male; Pediatrics; Retrospective Studies; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Adult; Anti-Infective Agents; Bartonella henselae; Cat-Scratch Disease; Chorioretinitis; Eye Infections, Bacterial; Female; Humans; Tomography, Optical Coherence; Trimethoprim, Sulfamethoxazole Drug Combination; Visual Acuity

Bartonella henselae is the causative agent of cat-scratch disease and other disorders, including hepatosplenic granulomatosis. This infection has only rarely been reported after solid organ transplantation, where it can mimic the more common post-transplant lymphoproliferative disease. Here we present a case of asymptomatic B. henselae hepatic and lymph nodal granulomatosis in a pediatric patient who had received orthotopic liver transplant 2 months before; we hypothesize that the causative agent was transmitted from the donor. This infection developed early in the post-transplant period; the disease involved only the graft liver and the regional lymph nodes, and the patient did not have a cat or any history of contact, scratches, or bites by a cat. In our patient this infection resolved successfully with a combination of 2 associated antibiotics and reduction of immunosuppressive therapy.

Topics: Amikacin; Anti-Infective Agents; Antibodies, Bacterial; Azithromycin; Bartonella henselae; Cat-Scratch Disease; Child; Humans; Immunosuppressive Agents; Liver; Liver Neoplasms; Liver Transplantation; Lymph Nodes; Lymphomatoid Granulomatosis; Male; Postoperative Complications; RNA, Bacterial; RNA, Ribosomal, 16S; RNA, Ribosomal, 23S; Tacrolimus; Tissue Donors; Transplants; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Ultrasonography

An otherwise healthy 9-year-old girl presented with bilateral recurrent anterior uveitis. Thirteen months later, the diagnosis of cat-scratch disease (ocular bartonellosis) was suspected when neuroretinitis appeared. Confirmation was based on serological test results positive for Bartonella henselae. Antibiotic treatment completely cured the disease, and there have been no further manifestations during a follow-up period of 6 years.

Topics: Anti-Bacterial Agents; Bartonella henselae; Cat-Scratch Disease; Child; Diagnosis, Differential; Female; Humans; Iridocyclitis; Trimethoprim, Sulfamethoxazole Drug Combination

Cat-scratch disease is a self-limited infection characterized by subacute regional lymphadenitis, which is usually preceded by a history of being scratched by a cat infected with the Bartonella species. Neuroretinitis, retinochoroiditis, isolated papillitis and peripapillary angiomatosis are features of posterior segment involvement. However, vision loss is very rare. We report a patient with cat-scratch disease associated with unilateral neuroretinitis and peripapillary serous retinal detachment, and discuss its fluorescein and indocyanine green angiographic features.

Topics: Adolescent; Animals; Anti-Infective Agents; Cat-Scratch Disease; Cats; Fluorescein Angiography; Humans; Indocyanine Green; Lymph Nodes; Male; Retinal Detachment; Retinitis; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Visual Acuity

Topics: Adult; Anti-Bacterial Agents; Antibodies, Bacterial; Bartonella henselae; Bartonella quintana; Cat-Scratch Disease; Child; Doxycycline; Eye Infections, Bacterial; Female; Fluorescein Angiography; Fundus Oculi; Humans; Immunoglobulin G; Immunoglobulin M; Optic Disk; Optic Neuritis; Trimethoprim, Sulfamethoxazole Drug Combination

Cat scratch disease is a subacute regional lymphadenitis usually preceded by a history of being scratched by a cat or young kitten. The spectrum of illness ranges from mild self-limited adenopathy to severe systemic disease, including hepatosplenomegaly, encephalopathy, osteolytic lesions, splenic abscesses, mediastinal masses, and neuroretinitis. Vision loss is a rare complication of the disease. The authors report a patient with cat scratch disease associated with acute febrile illness, lymphocytic meningitis, and acute vision loss secondary to neuroretinitis. To their knowledge, this is the first ophthalmic case reported in which the diagnosis is supported by both a positive skin test and positive histopathology.

Topics: Cat-Scratch Disease; Child; Dexamethasone; Female; Fundus Oculi; Humans; Optic Neuritis; Retinitis; Skin Tests; Trimethoprim, Sulfamethoxazole Drug Combination; Vision Disorders; Visual Acuity

Topics: Adolescent; Anti-Bacterial Agents; Cat-Scratch Disease; Child; Child, Preschool; Female; Georgia; Humans; Male; Pediatrics; Retrospective Studies; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Adolescent; Cat-Scratch Disease; Child; Child, Preschool; Georgia; Humans; Trimethoprim, Sulfamethoxazole Drug Combination