We report a case of cat scratch disease in an 8-yr-old girl who presented with fever and enlargement of both axillary lymph nodes. Both aerobic and anaerobic cultures of the lymph node aspirate were negative for microbial growth. Gram staining and Warthin-Starry silver staining did not reveal any organism. Purified DNA from the PCR-amplicon of the 16S-23S rRNA intergenic region was sequenced and showed 99.7% identity with the corresponding sequence of Bartonella henselae strain Houston-1. Our findings suggest that the internal transcribed spacer is a reliable region for PCR identification of Bartonella species. In patients with lymphadenitis, a history of contact with cats or dogs necessitates the use of diagnostic approaches that employ not only the conventional staining and culture but also molecular methods to detect B. henselae.
Animals ; Bartonella henselae/genetics/*isolation & purification ; Cat-Scratch Disease/complications/*diagnosis ; Cats ; Child ; Dogs ; Female ; Humans ; Lymphadenitis/complications ; *Polymerase Chain Reaction ; RNA, Ribosomal, 16S/*genetics ; RNA, Ribosomal, 23S/*genetics ; Republic of Korea ; Sequence Analysis, DNA

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.
Adolescent ; Animal ; Anti-Infective Agents/therapeutic use ; Case Report ; Cat-Scratch Disease/*complications/diagnosis/therapy ; Cats ; Fluorescein Angiography ; Human ; Indocyanine Green/diagnostic use ; Lymph Nodes/pathology ; Male ; Retinal Detachment/diagnosis/*etiology/therapy ; Retinitis/diagnosis/*etiology/therapy ; Treatment Outcome ; Trimethoprim-Sulfamethoxazole Combination/therapeutic use ; Visual Acuity