Epidemiological and Clinical Characteristics of Cat Scratch Disease in Adults in Lima, Peru. Case series. and literature review
DOI:
https://doi.org/10.20453/rmh.v36i3.6348Keywords:
Cat scratch disease, skin abnormalities, Bartonella henselae, antibacterialsAbstract
Objectives: To determine the epidemiological and clinical characteristics of cat scratch disease in adults in Lima, Peru. Methods: Descriptive, retrospective study carried out at the Hospital Nacional Cayetano Heredia in Lima and a Private Center in Lima, in the period between 2016 and 2025, in patients over 18 years of age. Results: Of eleven patients with cat scratch disease (CSD), ten presented the typical picture, the only patient affected by neuroretinitis did not present any lymph node symptoms, she did present fever of obscure origin and decreased visual acuity, 10 patients had positive IFA serology to Bartonella henselae (IgG and IgM), only one clinical and epidemiological CSD, six received azithromycin, one doxycycline, one combination of azithromycin + clindamycin, one azithromycin + doxycycline, one doxycycline + rifampicin; One case received azithromycin + gentamicin. The outcome was favorable in all. Conclusions: All patients had contact with cats, the vast majority had right epitrochlear lymph node involvement, only one case presented with fever of unknown origin and neuroretinitis, and 90.9% had serology + IIF for Bartonella henselae.
Downloads
References
Maguiña C, Soto L, Egoavil M, et al. Enfermedades de mascotas en humanos. Revisión actualizada. Rev Soc Peru Med Interna. 2004; 17(1):17-26.
Carithers HA. Cat-scratch disease: an overview based on a study of 1200 patients. Am J Dis Child. 1985;139(11):1124-33. doi: 10.1001/archpedi.1985.02140130062031.
Margileth AM. Antibiotic therapy for cat-scratch disease: Clinical study of therapeutic outcome in 268 patients and review of the literature. Pediatr Infect Dis. 1992; 11: 474-478.
Adal K, Cockerell C, Petri W. Cat-Scratch Disease, Bacillary Angiomatosis, and Other Infections Due to Rochalimaea. N Engl J Med. 1994; 330: 1509-15. doi:10.1056/NEJM199405263302108.
Bass J, Freitas B, Freitas A. Prospective randomized double-blind placebo-controlled evaluation of azithromycin for treatment of cat-scratch disease. Pediatr Infect Dis J. 1998;17: 447-52. doi: 10.1097/00006454-199806000-00002.
Nawrocki CC, Max RJ, Marzec NS, et al. Atypical Manifestations of Cat-Scratch Disease, United States, 2005-2014. Emerg Infect Dis. 2020; 26(7):1438-1446. doi: 10.3201/eid2607.200034.
Pelton S, Kim J, Kradin R. Case records of the Massachusetts General Hospital. Case 27-2006: A 17-Year-Old Boy with Fever and Lesions in the Liver and Spleen. N Engl J Med. 2006; 355:941-948. doi: 10.1056/NEJMcpc069017.
Umbreen G, Jabeen C. Case reports of cat scratch disease with typical and atypical clinical manifestations: a literature review. Int J Med Res Health Sci. 2017;6(4):51–4.
Mirakhur B, Shah S, Ratner A, et al. Cat scratch disease presenting as orbital abscess and osteomyelitis. J Clin Microbiol. 2003; 41: 3991-3. doi: 10.1128/JCM.41.8.3991-3993.2003.
Massei F, Gori L, Macchia P, et al. The expanded spectrum of bartonellosis in children. Infect Dis Clin North Am. 2005; 19: 691-711. doi: 10.1016/j.idc.2005.06.001.
Margileth AM. Recent advances in diagnosis and treatment of cat scratch disease. Curr Infect Dis Rep. 2000; 2(2):141-146. doi: 10.1007/s11908-000-0026-8.
Armitano R, Lisa A, Martínez C, et al. Bartonella henselae: evidencia serológica en pacientes pediátricos con sospecha clínica de enfermedad por arañazo de gato. Rev Argent Microbiol. 2018; 50(4):365-8.
Abarca K, Winter M, Marsac D, et al. Exactitud y utilidad diagnóstica de la IgM en infecciones por Bartonella henselae. Rev Chil Infectol. 2013; 30(2):125-8. Doi: 10.4067/S0716-10182013000200001.
Huarcaya E, Maguiña C, Cok J, et al. A prospective Study of cat Scratch disease in Peru. Rev Ins Med Trop Sao Paulo. 2002; 44(6): 325-330. doi:10.1590/s0036-46652002000600006.
Eymín G, Zapata A, Andrade M, et al. Enfermedad por arañazo de gato. Características clínicas y de laboratorio en pacientes adultos hospitalizados por fiebre o adenopatías Rev med Chile. 2006; 134(10):1243-1248. doi: 10.4067/S0034-98872006001000005.
Rodríguez EA, Ortuño RG, Giardullo C, et al. Características clínicas de pacientes adultos con enfermedad por arañazo de gato. Medicina (B Aires). 2024; 84:474–480.
Rivera A. Enfermedad por arañazo de gato en el hospital naval. Tesis para optar al grado de Bachiller en Medicina. Lima, Perú: Universidad Peruana Cayetano Heredia; 1999.
Polanco M, Cornejo M, Maguiña C. Primer reporte de enfermedad sistémica por arañazo de gato (Bartonella henselae) en el Perú. Acta méd Peruana.2008; 25(4):228-231.
Miranda-Choque E, Candela-Herrera J, Díaz-Pereda J, et al. Bartonella henselae en niños con adenitis regional atendidos en un hospital nacional del Perú. Rev Perú med exp salud publica. 2012; 31(2):274-277.
Del Pozo AA, Angulo-Cruzado M, Amenero-Vega R, et al. Abscesos hepatoesplénicos en un niño inmunocompetente con enfermedad por arañazo de gato del Perú. Ann Clin Microbiol Antimicrob. 2019; 18(1):23. doi: 10.1186/s12941-019-0322-0.
Sandoval A, Reyes F, Prado MA, et al. Cat-scratch Disease in the Pediatric Population. 6 years of evaluation and follow-up in the Public Hospital in Chile. Pediatr Infect Dis J. 2020; 39(10):889-93. doi: 10.1097/INF.0000000000002708.
Florín TA, Zaoutis TE, Zaoutis LB. Beyond cat scratch disease: Widening spectrum of Bartonella henselae infection. Pediatrics. 2008; 121(5):1413-25. doi: 10.1542/peds.2007-1897
Suhler E B, Lauer A K, Rosenbaum J T. Prevalence of serologic evidence of cat scratch disease in patients with neuro-retinitis. Ophthalmology 2000; 107: 871-6. doi: 10.1016/s0161-6420(00)00002-6.
Hertz A, Lahey M. Optic neuritis due to Bartonella henselae infection. N Engl J Med. 2004; 350: e1. doi: 10.1056/ENEJMicm010038.
Cunningham ET, Koehler JE. Ocular bartonellosis. Am J Ophthalmol. 2000;130(3):340-9. doi: 10.1016/s0002-9394(00)00573-0.
Tager M, Jahnsen, Mediavilla M, Burgos R. Bartonelosis ocular. Reporte de tres Casos. Rev Chil Infectol. 2008;25(1):58-63. Doi: 10.4067/S0716-10182008000100012.
Lee A. Systemic infections of neuro-ophthalmic significance. Opthalmol Clin North Am. 2004; 17: 397-425. doi: 10.1016/j.ohc.2004.05.002.
Deregibus M, Bagnara E, Buchovsky A. Enfermedad por arañazo de gato: experiencia en un hospital pediátrico de tercer nivel. Arch Argent Pediatr. 2023;121(1):1-6. doi: 10.5546/aap.2022-02592.
Rolain JM, Brouqui P, Koehler JE, Maguiña C. Recommendations for Treatment of Human Infections Caused by Bartonella Species. Antimicrob Agents Chemother. 2004; 48:1921-33. doi: 10.1128/AAC.48.6.1921-1933.2004.
Shorbatli L, Koranyi K, Nahata M. Effectiveness of antibiotic therapy in pediatric patients with cat scratch disease. Int J Clin Pharm. 2018; 40(6):1458-61. doi: 10.1007/s11096-018-0746-1.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Ciro Maguiña, Rosy Gastelo Acosta , Ketty Dolores Cerna
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors assign their rights to the RMH so that may disseminate the article through the means at their disposal. The journal will provide forms of affidavit of authorship and authorization for the publication of the article, which shall be submitted with the manuscript. Authors retain the right to share, copy, distribute, perform and publicly communicate their article, or part of it, mentioning the original publication in the journal.
