Unilateral Conjunctivitis With Multifocal Granulomatous Lesions in a Child Aged 10 Years

This case report discusses a diagnosis of Parinaud oculoglandular syndrome in a child aged 10 years who presented with a granulomatous conjunctivitis in the left eye.

Cat scratch lesions as a manifestation of chronic colitis due to spirochetosis

Barotrauma or cat scratch is an unusual finding on colonoscopy. The etiology is unknown, but insufflation associated with increased rigidity of the colonic wall due to various pathological processes has been postulated as a pathogenic mechanism. Some authors observed the same associated with collagenous colitis, IBD(Inflammatory Bowel Diseases), intestinal ischemia, shunt colitis and intake of NSAIDs (Non-steroidal anti-inflammatory drugs). In all the cases described, Co2 was used for insufflation.

Genetic diversity and Multilocus Sequence Typing Analysis of Bartonella henselae in domestic cats from Southeastern Brazil

Bartonella henselae is the causative agent for the infectious disease Cat Scratch Disease (CSD), which can be fatal. Domestic and wild felines are known to be its main mammal reservoirs. The present study aimed to investigate the occurrence and genetic diversity of Bartonella spp. in cats sampled in São Paulo (SP) and Minas Gerais (MG) States, Southeastern Brazil. Based on a quantitative real-time PCR (qPCR) assay, a Bartonella sp. nuoG gene fragment was detected in 39.9% (122/306) of the blood samples (46/151 cats of SP; 76/155 cats of MG). The blood samples were submitted to a pre-enrichment culture technique that allowed the detection of 12 additional positive samples, which showed to be negative in the qPCR using DNA blood samples as templates. Furthermore, five B. henselae isolates were obtained from qPCR-negative samples for both blood and pre-enrichment culture. Seven out of 24 Ctenocephalides felis fleas were positive for Bartonella spp. in the qPCR assay; 4/7 positive fleas were collected from Bartonella-negative cats. Twenty-three rpoB B. henselae cloned sequences were obtained from nine cats' blood samples, showing the occurrence of 13 different genotypes. Median-joining network and SplitsTree distance analysis showed that the obtained sequences represented distinct B. henselae genotypes when compared to those previously deposited in GenBank. Intra-host diversity was found, since different rpoB genotypes of B. henselae were detected in individual single cats. Bartonella henselae isolates showed two allelic profiles (ST37 in cats from MG state and ST9 in SP state) by MLST (Multilocus Sequence Typing) based on sequencing of eight molecular markers. The present study is the first molecular report of Bartonella sp. in cats from Minas Gerais State. In summary, this body of work showed the occurrence of different B. henselae rpoB genotypes at an intra-reservoir host level. Based on qPCR from blood samples and pre-enrichment liquid culture and isolation, occurrence of 33.1% (50/151) and 56.8% (88/155) for Bartonella sp. was found in cats from SP and MG states, respectively. Two different allelic profiles of B. henselae were found in cats from the states of São Paulo (ST9) and Minas Gerais (ST37), suggesting a clonal evolution of Bartonellae in a certain geographical region.

[Cat-scratch disease]

We present three clinical cases to show the diversity of clinical presentations of Bartonella henselae infection, from classical adenopathy to disseminated form. It is an infection that leads to diagnostic wandering, due to a lack of explicit history and the variety of clinical manifestations. Antibiotic therapy is rarely necessary because it has a spontaneously favourable evolution in the majority of cases.

; CLINICAL AND LABORATORY CHARACTERISTICS OF ACUTE LYMPHADENITIS IN CHILDREN

The aim of the study is to determine the clinical and laboratory characteristics of acute lymphadenitis in children.; The study was performed using retrograde analysis of diagnosis and treatment of 158 children with acute lymphadenides of nonspecific and specific etiology, different localization (submandibular, cervical, axillary, inguinal and other peripheral localization) who were treated at the inpatient department in the pediatric surgery of MHCF "Local oncologic dispensary of Kramatorsk" from 2015 to 2019. Among the inpatient children there were 86 (54.4%) boys and 72 (45.6%) girls. The age of the patients ranged from 2 months to 18 years. The average age of the patients was 5.8±0.61 years. The surgical procedures were performed in 131 patients (82.9%) while the non-specific nature of the inflammatory process was confirmed in 102 patients (77.9%) taking into account the clinical course of the disease and the results of microbiological analysis. A specific inflammatory process was found out in 29 patients (22.1%). It was clinically detected that 18 children (13.7%) had BCG-lymphadenitis (confirmed by histological examination) and 11 patients (8.4%) had benign lymphoreticulosis (felinosis) among them.; Due to the use of shear wave elastography 62.9% of the children were able to avoid any surgery, extra puncture and they were treated conservatively.

[Cat scratch disease with deradenoncus and high fever: report of one case]

Cat scratch disease (CSD) is a bacterial disease caused by Bartonella henselae. It is mainly characterized by self-limiting lymphadenopathy in the draining site after cat scratch or bite. This paper reported a case of cat scratch disease with deradenoncus and high fever, and discussed the etiology, pathogenesis, epidemiology, pathology, clinical characteristics, diagnosis and treatment methods of CSD.

Lymph nodes fine needle cytology in the diagnosis of infectious diseases: clinical settings

Lymph node reactive hyperplasia, caused by specific infectious etiologic factors, represents the most frequent cause of enlarged peripheral lymph nodes. The main infectious agents are viruses, pyogenic bacteria, mycobacteria, fungi and protozoa that may determine unspecific or specific pathological entities, such as cat-scratch disease, toxoplasmosis or infectious mononucleosis. Lymph node fine needle cytology (FNC) is a safe, simple, cost-effective and efficient technique that quickly provides information about the cell population and the nature of the process. FNC can also provide suitable material for ancillary techniques, such as flow cytometry, immunocytochemistry, molecular biology and microbiological examinations. This study focuses on the cytological features of benign lymphadenopathy of infectious origin and their possible contribution to the clinical setting definition of corresponding patients.

[A 34-year-old woman with cat scratch disease who developed encephalopathy]

We experienced a patient with cat-scratch disease (CSD) who developed encephalopathy. The subject was a 34-year-old female who had been aware of a low-grade fever and swollen inguinal lymph nodes for 1 month. The subject's consciousness became impaired after a headache developed, accompanied by fever, nausea, and vomiting, and she subsequently sought medical consultation. No major abnormalities were observed in the cerebrospinal fluid and cranial magnetic resonance imaging (MRI) was normal. However, necrotizing lymphadenitis was observed on contrast enhanced computed tomography (CT) of the pelvis and granulomatous changes were observed in a surgical lymph node biopsy. As the subject lived with a pet cat, PCR testing for Bartonella henselae (the CSD pathogen) was performed using a tissue biopsy. This was positive and the subject was diagnosed with CSD encephalopathy. There are very few domestic reports of CSD encephalopathy and care must be taken not to overlook this disease.

Cat scratch disease: a diagnostic dilemma

Cat scratch disease (CSD) caused by Bartonella henselae is the most common Bartonella infection worldwide. CSD usually presents as self-limiting lymphadenitis characterized by lymphadenopathy that occurs after contact with a cat and the symptoms resolve within 2 to 4 months. Serology testing is the cornerstone of diagnosis. However, it may require the use of clinical specimens for microbiologic evaluation for diagnosis. A number of antimicrobial agents have been advocated for the treatment of cat-scratch disease and treatment with azithromycin has been shown to be beneficial.

Neurorétinite à Bartonella henselae : maladie des griffes du chat

We report a case of cat-scratch disease neuroretinitis for which systemic and ocular investigations proved the responsibility of Bartonella henselae. An 11-year-old boy was referred to the hospital in November 2002 for severe visual loss in the left eye over the preceding 2 weeks. At the same time, he also developed a flu-like illness. The best corrected acuity in the left eye was counting fingers at 30 cm. Posterior segment examination on the left eye showed an optic disk edema with papillary and peripapillary hemorrhages and serous retinal detachment, mild vitreous inflammation, and two little perivascular white spots. The medical history was unremarkable except for a cat scratch on his left forearm 2 months before. Four weeks of antibiotic therapy including oral rifampin and doxycycline was used. Bartonella henselae immunoglobulin M were first detected with Bartonella henselae immunoglobulin G testing negative at this time. A 3-week serum showed immunoglobulin M seroreversion, while Bartonella henselae immunoglobulin G appeared. Other causes of optic disk edema with macular star were excluded by biological data. Bartonella antibodies to both Bartonella henselae and Bartonella clarridgeiae were detected in the cat. Ophthalmic follow-up showed progressive resorption of the neuroretinitis and the visual acuity increased to 5/10. The significance of this case report lies in the reminder that this pathology can be the cause of neuroretinitis; the prognosis can be improved by earlier treatment.

Inflammation of the breast

The primary care physician usually is the first person to see patients complaining of breast pain or nipple discharge. The diagnosis of lactational mastitis is evident because of the history The major consideration is prompt and effective treatment and close follow-up evaluation. Failure to respond to appropriate therapy should suggest abscess formation, and prompt intervention is required. Any diagnosis of mastitis in a patient who is not lactating should be viewed with suspicion. Although several benign and non-life-threatening conditions have been discussed herein, inflammatory breast cancer must always be considered.

Cat scratch disease: no longer a diagnostic dilemma

Cat scratch disease is a relatively common cause of localized lymphadenopathy with about 80% of cases occurring in children. This self-limited infection is caused by a small pleomorphic gram-negative bacillus that has been identified in ocular granulomas, skin and lymph node specimens. Unusual manifestations of the disease, such as the oculoglandular disease of Parinaud, encephalopathy, or severe systemic disease, occur in about 12% of patients. Management consists of symptomatic treatment, occasionally aspiration of a node or selected antibiotic therapy in moderate to severely ill patients. Persistence of adenopathy for several months in a generally healthy patient with gradual, spontaneous resolution of the enlarged node is the natural course.

Zoonoses

Animal-transmitted diseases are remarkable not because they occur frequently but because they are almost always unsuspected and unrecognized. The physician who attends an ill veterinarian or zookeeper will immediately suspect an exotic disease. The pediatrician who attends the child who recently received a puppy for his birthday will not. Our public attitude toward animals as carriers of disease is utterly thoughtless. If a human were to urinate and defecate in the street or park he would be incarcerated without delay. Yet we tolerate and even encourage the same activity in dogs, which are known to carry scores of diseases to humans. Animals as pets are here to stay. Children are their frequent companions. It would serve all those who deal with the medical problems of children to know as much as possible about the diseases carried by animals, for their consequences are quite significant.