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Cat-scratch disease in an immunocompromised host.
Med Sci Monit 2002; 8(3):CS26-9MS

Abstract

BACKGROUND

The main causative agents of cat-scratch disease are Bartonella henselae, tiny, gram-negative bacilli. The disease usually has a benign course with the development of a papule at the inoculation site, followed by regional lymphadenopathy. In most cases, complete resolution occurs, but in immunocompromised hosts, the course of the disease can be aggravated.

CASE REPORT

A patient received methotrexate and corticosteroids for 3 months due to rheumatoid arthritis. He developed fever, exanthema and leukopenia under methotrexate therapy. Dark red indurations with central ulcerations at his right thigh revealed a further problem apart from the methotrexate-induced leucopenia and immunosuppression. The ulcerations were the remainders of recurrent scratches from the patient's cat. The patient's antibody titers against Bartonella henselae remained low and inguinal lymph node swelling was only for a short time to be observed, this reaction obviously weakened as a result of the immunosuppression. However, the typical course, the exclusion of other reasons for the exanthema and the rapid improvement of the patient's condition after antibiotic treatment ascertained the diagnosis.

CONCLUSIONS

In immunocompromised hosts, diseases with a typically benign course can become severe and life-threatening illnesses. Ownership of pets should be taken into consideration before onset of an immunosuppressive therapy.

Authors+Show Affiliations

1st Department of Medicine, Friedrich-Alexander University, Erlangen-Nuremberg, Erlangen, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

11887039

Citation

Harsch, Igor Alexander, et al. "Cat-scratch Disease in an Immunocompromised Host." Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, vol. 8, no. 3, 2002, pp. CS26-9.
Harsch IA, Schahin SP, Schmelzer A, et al. Cat-scratch disease in an immunocompromised host. Med Sci Monit. 2002;8(3):CS26-9.
Harsch, I. A., Schahin, S. P., Schmelzer, A., Hahn, E. G., & Konturek, P. C. (2002). Cat-scratch disease in an immunocompromised host. Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, 8(3), pp. CS26-9.
Harsch IA, et al. Cat-scratch Disease in an Immunocompromised Host. Med Sci Monit. 2002;8(3):CS26-9. PubMed PMID: 11887039.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cat-scratch disease in an immunocompromised host. AU - Harsch,Igor Alexander, AU - Schahin,Simin Pour, AU - Schmelzer,Alexander, AU - Hahn,Eckhart Georg, AU - Konturek,Peter Christopher, PY - 2002/3/12/pubmed PY - 2002/7/23/medline PY - 2002/3/12/entrez SP - CS26 EP - 9 JF - Medical science monitor : international medical journal of experimental and clinical research JO - Med. Sci. Monit. VL - 8 IS - 3 N2 - BACKGROUND: The main causative agents of cat-scratch disease are Bartonella henselae, tiny, gram-negative bacilli. The disease usually has a benign course with the development of a papule at the inoculation site, followed by regional lymphadenopathy. In most cases, complete resolution occurs, but in immunocompromised hosts, the course of the disease can be aggravated. CASE REPORT: A patient received methotrexate and corticosteroids for 3 months due to rheumatoid arthritis. He developed fever, exanthema and leukopenia under methotrexate therapy. Dark red indurations with central ulcerations at his right thigh revealed a further problem apart from the methotrexate-induced leucopenia and immunosuppression. The ulcerations were the remainders of recurrent scratches from the patient's cat. The patient's antibody titers against Bartonella henselae remained low and inguinal lymph node swelling was only for a short time to be observed, this reaction obviously weakened as a result of the immunosuppression. However, the typical course, the exclusion of other reasons for the exanthema and the rapid improvement of the patient's condition after antibiotic treatment ascertained the diagnosis. CONCLUSIONS: In immunocompromised hosts, diseases with a typically benign course can become severe and life-threatening illnesses. Ownership of pets should be taken into consideration before onset of an immunosuppressive therapy. SN - 1234-1010 UR - https://www.unboundmedicine.com/medline/citation/11887039/Cat_scratch_disease_in_an_immunocompromised_host_ L2 - https://www.medscimonit.com/download/index/idArt/420899 DB - PRIME DP - Unbound Medicine ER -