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Cat scratch disease (CSD) is caused by Bartonella henselae ( B. henselae ) and presents as lymphadenopathy following close contact with cats. However, in context of the global COVID-19 pandemic, clinical manifestations of CSD may vary, posing new challenges for healthcare professionals. Here we describe a case of a 54-year-old male with painful left upper arm mass, which gradually resolved until he was infected with COVID-19. The mass then rapidly progressed before admission. Meanwhile, pulmonary symptoms including pleural effusion emerged simultaneously. The cause was undetermined with routine blood culture and pathological test until the next generation sequencing (NGS) confirmed the presence of B. henselae . We believe this case is the first to report localized aggravation of CSD after COVID-19 infection and hopefully, offers treatment experience for clinicians worldwide.

Bartonella species are known as candidates for zoonotic transmission, and cats serve as the main reservoir for Bartonella henselae , the primary causative agent of cat scratch disease (CSD). However, research on the transmission of bartonellosis to humans remains very limited. In East Asia, there is a lack of comprehensive studies regarding the prevalence of B. henselae infection and its associated risk factors among companion cats, their owners, and individuals working in veterinary professions. This study aimed to investigate both the molecular and seroprevalence of B. henselae in veterinary personnel and companion cats in South Korea, along with a questionnaire‐based analysis of transmission risk factors. Blood and saliva samples were collected from humans, whereas blood, saliva, claw, and fecal samples were obtained from cats. Seroprevalence and molecular prevalence were measured for all these samples. Additionally, participants were required to complete an epidemiological information questionnaire related to CSD. The study enrolled 300 veterinary professionals and 126 companion cats owned by them. The serum IgG prevalence in humans was 64.6% (190/294), whereas, in cats, it was 5.5% (6/108). The molecular prevalence in human blood and saliva was 3% (9/298) and 1.7% (5/298), respectively. In cats, it was 10.1% (12/119) for blood, 0% (0/123) for saliva, 1.7% (2/119) for nails, and 4.5% (5/112) for feces. Phylogenetic analysis of the PCR‐positive samples confirmed that all of them were B. henselae . This study demonstrates that Bartonella species are widespread among veterinary professionals in South Korea, highlighting their significance as zoonotic pathogens. Given the potential for indirect transmission from cats, enhancing awareness of Bartonella exposure risk among veterinary personnel is warranted, along with emphasizing preventive education for cat owners, including strict ectoparasite control.

Cat scratch disease (CSD) is an infectious disease caused by Bartonella henselae, usually characterized by self-limiting regional lymphadenopathy and fever. Given the low clinical diagnostic sensitivity and specificity of conventional anti-B. henselae indirect immunofluorescence assays (IFAs), real-time polymerase chain reaction (PCR)-based detection of B. henselae is now being proposed as a more sensitive tool to diagnose CSD. Thus, here we have assessed the efficacy of real-time PCR in detecting B. henselae in different specimens from patients with suspected CSD and compared it to that of IFA. From March 2011 to May 2016, at the Microbiology and Virology Unit, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy, 115 clinical specimens (56 aspirated pus, 39 fresh lymph node biopsies, and 20 whole blood samples) and 99 sera from 115 patients with suspected CSD (62 females and 53 males between the ages of 3 months and 68 years) were analyzed by both real-time PCR, used in a qualitative way, and IFA (IgM and IgG) for the presence of B. henselae. For 16 patients, serological results were not available due to a clinical decision not to request the test. B. henselae DNA positivity was detected by real-time PCR in 37.39% of patients, while 62.61% of them were negative. Thus, patients were divided into two groups: real-time PCR+ (n = 43) and real-time PCR- (n = 72). Real-time PCR screening of whole blood, biopsies, and aspirated pus revealed B. henselae positivity in 40%, 38.46%, and 35.71% of patients, respectively. When we analyzed samples by IFA, we found the presence of B. henselae in 28 out of 99 (28.28%) patients, of which 11 (11.11%) belonged to the real-time PCR+ group and 17 (17.17%) to the real-time PCR- group. Among the 71 seronegative subjects, 16 (16.16%) were found positive for B. henselae by real-time PCR. Thus, by combining the results of both assays, we were able to increase the percentage of B. henselae positive specimens from 27.27% (real-time PCR) or 28.28% (IFA) to 44.44% (real-time PCR+IFA). Altogether, these findings indicate that the early detection of B. henselae in patients with suspicious CSD through combined real-time PCR and serological analyses can lead to a more accurate diagnosis of CSD, thereby allowing prompt and appropriate disease management.

To describe unusual findings and management of neuroretinitis in patients with cat scratch disease (CSD), their functional outcome after a case-oriented treatment was anaylsed, and the current literature was reviewed. A retrospective monocentric case series and a literature review. Review of medical records, multimodal imaging, and literature review. Five patients (four females and one male) with a mean age of 29.75 years (range: 11–71 years) had unusual findings of ocular bartonellosis, including inner retinitis, focal choroiditis, retinal microaneurysms, and bilateral sectorial optic nerve swelling. Bartonella-related ocular infections were not limited to the posterior segment of the eye. Molecular tests, such as polymerase chain reaction (PCR), showed that elevated markers of IgG titers were used and were positive in the aqueous humour of one patient. Reference to the use of intravitreal treatment in one of the cases was useful. Case-oriented management is associated with improvement in visual acuity, retinal, and choroidal lesions. The range of ocular signs of Bartonella infection could be extended. Molecular tests, such as PCR, are useful diagnostic approaches in the diagnosis of posterior uveitis. Treatment could require intravitreal antibiotic injections in unusual ocular bartonellosis.

Cat scratch disease (CSD) is an infection caused by Bartonella henselae, presents with non-specific symptoms like lymphadenopathy, fever, and fatigue. It can progress to disseminated disease, leading to complications such as liver and splenic micro abscesses, osteomyelitis, encephalitis, and uveitis. Diagnosis is challenging due to varied presentations and limited tests. Treatment involves supportive care, with severe cases requiring antimicrobial therapy. In this report, we present a case of Cat scratch disease characterized by an atypical clinical manifestation, hepatosplenic and paravertebral involvement.

Neuroretinitis connotes a descriptive clinical entity of optic disc oedema in association with macular exudates in a star configuration. Accordingly, it does not indicate a specific aetiology, although cat scratch disease caused by Bartonella henselae is the most common cause. Historically, the recognition of neuroretinitis dates to the early 20 th century with the eventual understanding that the optic disc is the primary target of disease with secondary macular involvement. Neuroretinitis can be broadly divided into four categories: infectious, inflammatory, autoimmune and mimickers. The intention of this article is to review the various aetiologies of neuroretinitis with a focus on the etiopathogenesis, clinical manifestations, and management of B. henselae associated neuroretinitis and recurrent idiopathic neuroretinitis.

Abstract A 2.5-year-old castrated male cat presented with fever and marked generalized lymphadenopathy of 4-months duration, despite treatment with amoxicillin-clavulanate/marbofloxacin. Abnormalities were not detected on complete blood count, serum chemistry, and FIV/FeLV test apart from a borderline, non-regenerative anemia. Peripheral lymph node fine needle aspirations revealed a marked increase in the percentage of intermediate- and lymphoblastic-lymphocytes in addition to reactive macrophages. Three weeks after presentation, the cat developed a severe, regenerative, immune-mediated hemolytic anemia (IMHA) which responded to immunosuppressive therapy. Fever and lymphadenopathy persisted. Peripheral lymph nodes tested positive for Bartonella henselae DNA in real-time PCR assay and sequencing. Treatment with pradofloxacin and doxycycline resulted in resolution of clinical signs, and negative PCR tests. Despite its reported low pathogenicity, B. henselae infection should also be considered in cats with protracted unexplained fever, lymphadenitis, and IMHA. Furthermore, a combination of pradofloxacin and doxycycline might be considered in cats with bartonellosis given its apparent clinical efficacy.

We studied retrospectively 651 PCR-confirmed Bartonella infections diagnosed at the French reference center for bartonellosis from 2014 to 2019. The most common form was cat-scratch disease (89%) followed by endocarditis (9%). Disseminated forms (2%) mainly presented as bacillary angiomatosis or peliosis hepatis in solid organ transplant recipients.

Cat-scratch disease, a worldwide zoonosis caused by the gram-negative bacteria B. henselae, is characterized by a benign, self-limiting regional lymphadenopathy that develops 1-8 weeks after a domestic feline scratch or bite. About 22,000 cases of catscratch disease are diagnosed annually in the US, predominately in children. Here, Chen et al examine the case of a 10-year-old boy with catscratch disease.

Background. Cat scratch disease (CSD) presents with diverse symptoms; however, meningitis as a complication is rare, and effective treatment strategies remain underexplored. Case Presentation. An 11-year-old girl presented with a prolonged fever of unknown origin, mild cough, and headache. Metagenomic next-generation sequencing (mNGS) identified Bartonella henselae in the bloodstream, and cerebrospinal fluid analysis confirmed meningitis. The patient was diagnosed with CSD complicated by meningitis and demonstrated a successful recovery following treatment with doxycycline, rifampicin, and prednisone. Conclusions. In CSD patients presenting with headaches and persistent fever, the possibility of meningitis should be considered. mNGS is a valuable diagnostic tool for CSD, especially in cases of fever of unknown origin. The combination of doxycycline, rifampicin, and prednisone proved effective in managing CSD with meningitis.