Asunto(s)
Artritis Reumatoide/tratamiento farmacológico , Bartonella henselae/aislamiento & purificación , Terapia Biológica/efectos adversos , Enfermedad por Rasguño de Gato/patología , Espondilitis Anquilosante/tratamiento farmacológico , Abatacept/uso terapéutico , Anciano , Animales , Anticuerpos Monoclonales/uso terapéutico , Artritis Reumatoide/diagnóstico , Terapia Biológica/métodos , Biopsia con Aguja , Enfermedad por Rasguño de Gato/diagnóstico , Gatos , Femenino , Estudios de Seguimiento , Humanos , Inmunohistoquímica , Medición de Riesgo , Muestreo , Adulto JovenAsunto(s)
Bartonella henselae/aislamiento & purificación , Enfermedad por Rasguño de Gato/microbiología , Enfermedad por Rasguño de Gato/transmisión , Trasplante de Hígado , Reacción a la Transfusión , Bartonella henselae/fisiología , Niño , Humanos , Trasplante de Hígado/efectos adversos , MasculinoRESUMEN
INTRODUCTION: Cat scratch disease is an infection due to Bartonella henselae. It is one of the principal causes of benign chronic adenopathy in children or young adults. CASE REPORT: A 36-year-old woman presented with a left parotid pre-auricular swelling suggesting a pleiomorphic adenoma. The history and complementary tests (ultra sonography, MRI, cytopuncture, B. henselae serology) led to a diagnosis of cat scratch disease. Doxycilline was efficient within 15 days. DISCUSSION: The parotid localization of cat scratch disease is very rare. When a patient presents with parotid swelling, the distinction between a tumor and lymph node is not easy. Performing complementary tests can be in balance with a quicker but sometimes inappropriate surgical indication. The diagnosis is made even more difficult because of delayed specific serologic tests as for B. henselae.
Asunto(s)
Enfermedad por Rasguño de Gato/diagnóstico , Enfermedades de las Parótidas/diagnóstico , Adulto , Antibacterianos/uso terapéutico , Bartonella henselae/aislamiento & purificación , Diagnóstico Diferencial , Doxiciclina/uso terapéutico , Femenino , Humanos , Neoplasias de la Parótida/diagnósticoRESUMEN
OBJECTIVES: To elucidate kinetics of Bartonella henselae bacteremia and IgG response, evaluate antibiotic therapy, and investigate challenge exposure in cats. ANIMALS: Specific-pathogen-free cats. PROCEDURE: Cats were inoculated with B henselae or B quintana and monitored. Convalescent cats were challenge exposed with B henselae. Amoxicillin, enrofloxacin, erythromycin, and tetracycline HCl were evaluated for effect on B henselae bacteremia. RESULTS: Cats developed B henselae bacteremia within 1 week; bacteremia persisted for longer than 2 months before subsiding spontaneously. IgG antibody titer developed shortly after onset of bacteremia; antibody co-existed with bacteremia for several weeks and remained detectable after bacteremia subsided. Cats inoculated with B quintana remained abacteremic. On challenge exposure to B henselae, cats previously infected with B henselae remained abacteremic; cats previously inoculated with B quintana supported B henselae infection. Tetracycline HCl and erythromycin depressed B henselae bacteremia; however, duration of bacteremia remained similar to that in untreated cats. Obvious signs of illness were not observed. CONCLUSIONS: Long-duration, high-titer B henselae infections were highly reproducible in cats. Convalescent cats were immune to reinfection. B quintana-inoculated cats did not have evidence of infection and were susceptible to B henselae challenge exposure. Antibiotic therapy was incompletely efficacious in terminating cat bacteremia. CLINICAL RELEVANCE: A cat with an inapparent B henselae infection must provisionally be regarded as a possible reservoir for infection for a minimum of 2 to 3 months. Convalescent cats are resistant to reinfection. Usual antibiotic therapy was not completely efficacious. Measurement of IgG antibody can be used to detect past or current infection.