Assuntos
Doença da Arranhadura de Gato , Imageamento por Ressonância Magnética , Retinite , Feminino , Humanos , Bartonella henselae , Doença da Arranhadura de Gato/complicações , Doença da Arranhadura de Gato/diagnóstico por imagem , Doença da Arranhadura de Gato/diagnóstico , Retinite/diagnóstico por imagem , Retinite/diagnóstico , Pessoa de Meia-IdadeRESUMO
Bartonella henselae infection is a prevalent illness in Chile. It presents generally as a cat scratch disease or as a prolonged fever syndrome. There are atypical manifestations, which include central nervous system, bone, cardiac and hepato-esplenic compromised. We present an adolescent case with a history of fever, vomiting and ataxia, whose diagnosis was a central nervous system infection by Bartonella henselae associated with a choroid plexus papilloma. This case corresponds to an unusual presentation, with a challenging diagnosis. It is controversial whether to treat this patient, which antimicrobial is the right choice and how long the treatment should be.
Assuntos
Doença da Arranhadura de Gato/diagnóstico por imagem , Infecções do Sistema Nervoso Central/microbiologia , Papiloma do Plexo Corióideo/diagnóstico por imagem , Adolescente , Biópsia , Doença da Arranhadura de Gato/complicações , Doença da Arranhadura de Gato/patologia , Infecções do Sistema Nervoso Central/diagnóstico por imagem , Infecções do Sistema Nervoso Central/patologia , Feminino , Humanos , Papiloma do Plexo Corióideo/complicações , Papiloma do Plexo Corióideo/patologia , Tomografia Computadorizada por Raios XRESUMO
Bartonella henselae infection is a frequent zoonosis from the domestic cat. It is presented with regional lymphadenitis in the majority of cases. Searching and characterization of lymph nodes by diagnostic imaging can be useful in the differential diagnosis approach, with a clear advantage, because it is a noninvasive method. Currently, new diagnostic imaging techniques improves the quality of screening and characterization of adenopathies, such is the case of PET/CT, which allows a better evaluation of hypermetabolic lymph nodes, without considering the individual growth of each lymph node. In this article, three cases of cat scratch diseases serology and their respective imaging findings are reviewed.
Assuntos
Doença da Arranhadura de Gato/diagnóstico por imagem , Linfonodos/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Resumen La infección por Bartonella henselae es una enfermedad prevalente en nuestro país. En general, se presenta como la enfermedad por arañazo de gato o un síndrome febril prolongado. Existen manifestaciones atípicas dentro de las cuales está el compromiso óseo, cardíaco, hepatoesplénico y del sistema nervioso central. Se presenta el caso de una adolescente con historia de vómitos, fiebre y ataxia, en que se diagnosticó una infección por Bartonella henselae con compromiso del sistema nervioso central, asociada a un papiloma del plexo coroídeo. Este caso corresponde a una presentación inusual, de difícil diagnóstico. Su tratamiento es motivo de controversia, tanto en si es necesario tratar, la elección del antimicrobiano, como su duración.
Bartonella henselae infection is a prevalent illness in Chile. It presents generally as a cat scratch disease or as a prolonged fever syndrome. There are atypical manifestations, which include central nervous system, bone, cardiac and hepato-esplenic compromised. We present an adolescent case with a history of fever, vomiting and ataxia, whose diagnosis was a central nervous system infection by Bartonella henselae associated with a choroid plexus papilloma. This case corresponds to an unusual presentation, with a challenging diagnosis. It is controversial whether to treat this patient, which antimicrobial is the right choice and how long the treatment should be.
Assuntos
Humanos , Feminino , Adolescente , Doença da Arranhadura de Gato/diagnóstico por imagem , Infecções do Sistema Nervoso Central/microbiologia , Papiloma do Plexo Corióideo/diagnóstico por imagem , Biópsia , Doença da Arranhadura de Gato/complicações , Doença da Arranhadura de Gato/patologia , Tomografia Computadorizada por Raios X , Infecções do Sistema Nervoso Central/patologia , Infecções do Sistema Nervoso Central/diagnóstico por imagem , Papiloma do Plexo Corióideo/complicações , Papiloma do Plexo Corióideo/patologiaRESUMO
Resumen La infección por Bartonella henselae es una zoonosis frecuente transmitida por el gato doméstico. En la mayoría de los casos se presenta con una linfadenitis regional. La búsqueda y caracterización de los ganglios linfáticos por imagenología puede ser útil en el diagnóstico diferencial, con la ventaja de ser un método no invasor. En la actualidad, nuevas técnicas de diagnóstico por imagen han mejorado la detección y caracterización de las adenopatías, tal es el caso de la tomografía por emisión de positrones (PET/CT) que permite la evaluación de ganglios linfáticos hipermetabólicos, de manera independiente del crecimiento individual de cada ganglio linfático. Se revisan tres casos de enfermedad por arañazo de gato y sus estudios imagenológicos respectivos.
Bartonella henselae infection is a frequent zoonosis from the domestic cat. It is presented with regional lymphadenitis in the majority of cases. Searching and characterization of lymph nodes by diagnostic imaging can be useful in the differential diagnosis approach, with a clear advantage, because it is a noninvasive method. Currently, new diagnostic imaging techniques improves the quality of screening and characterization of adenopathies, such is the case of PET/CT, which allows a better evaluation of hypermetabolic lymph nodes, without considering the individual growth of each lymph node. In this article, three cases of cat scratch diseases serology and their respective imaging findings are reviewed.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Doença da Arranhadura de Gato/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Linfonodos/diagnóstico por imagem , SeguimentosRESUMO
AIM: The objective of this study was to evaluate the degree and incidence of bone involvement in patients with cat scratch disease. METHODS: Patients admitted between 2004 and 2011 at the pediatric department for cat scratch disease and a positive serology for Bartonella henselae were identified. Only those having undergone a bone scintigraphy (BS) were included in this retrospective study. RESULTS: Sixteen girls and 8 boys with a mean age of 7 years were studied. Bone scintigraphy was positive in 6 (25%), but only 2 had bone pain. Axial involvement was present in all 6 patients, and appendicular lesions in 3 of them. Three patients had a BS control, with improvement or normalization after treatment with antibiotics. CONCLUSIONS: Bone involvement occurs infrequently in patients with cat scratch disease and is not always associated with specific signs. Cat scratch disease must be suspected in patients with fever of unknown origin presenting multifocal lesions on BS.
Assuntos
Osso e Ossos/diagnóstico por imagem , Doença da Arranhadura de Gato/diagnóstico por imagem , Adolescente , Antibacterianos/uso terapêutico , Doença da Arranhadura de Gato/tratamento farmacológico , Criança , Pré-Escolar , Feminino , Hospitais , Humanos , Masculino , Admissão do Paciente , CintilografiaAssuntos
Humanos , Feminino , Adolescente , Esplenopatias/complicações , Esplenopatias/diagnóstico por imagem , Doença da Arranhadura de Gato/complicações , Doença da Arranhadura de Gato/diagnóstico , Doença da Arranhadura de Gato/diagnóstico por imagem , Bartonella henselae/isolamento & purificação , Abscesso/diagnóstico , Baço/diagnóstico por imagem , UltrassonografiaRESUMO
BACKGROUND: Cat-scratch disease (CSD) is considered to be an emerging disease worldwide and is caused by Bartonella henselae, a gram-negative bacterium introduced by a scratch or bite of a cat. The most common clinical manifestation is regional lymphadenopathy, but clinical recognition may be difficult, as atypical manifestations may occur. The diagnosis is confirmed with serologic testing and histology is rarely needed. This paper is based on our experience with the use of ultrasonography in the diagnosis of CSD. OBJECTIVE: The aim of this study was to describe the sonographic and color Doppler appearances of regional lymphadenopathy in CSD, as this has not widely reported in the literature. MATERIALS AND METHODS: Forty-seven patients (average 9.4 years) were included who all had serologically and/or histologically proven CSD and had been studied using US early in the clinical course. All had a positive history of exposure to cats and exhibited regional lymphadenopathy. RESULTS: US showed large hypoechoic adenopathy with some transmission enhancement and high vascularization on color-flow Doppler imaging. In 30 patients, abdominal US was also performed and splenic and/or hepatic granulomata were found in 10. CONCLUSIONS: In our experience, sonography and especially color-Doppler and power-Doppler sonography was helpful in the diagnosis of CSD. We believe it should be used in the initial study of children with regional lymphadenopathy, and serologic testing should be performed when CSD is suspected.