Bartonellosis: suggestive case reports in adult and pediatric patients and therapeutic issues

Detalhes bibliográficos
Autor(a) principal: Manfredi,Roberto
Data de Publicação: 2006
Outros Autores: Sabbatani,Sergio
Tipo de documento: Relatório
Idioma: eng
Título da fonte: Brazilian Journal of Infectious Diseases
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702006000600012
Resumo: Cat-scratch disease warrants extensive investigation, from an epidemiological, a diagnostic, but especially a therapeutic point of view. Two suggestive episodes of Bartonella henselae-caused cat-scratch disease are reported, and discussed in the light of the most recent literature evidence. The first case occurred in a 60-year-old man, thus suggesting that it is important to maintain an elevated level of suspicion for this disease in adults as well. Both episodes were characterized by a very prolonged and complicated disease course (with the involvement of three lymph node sets in the first case), a need for lymph-node drainage, and apparently negligible activity of many antimicrobial courses, with a very slow local cure. While specific culture and molecular biology techniques proved negative (probably due to late availability of appropriate clinical specimens), indirect immunofluorescence antibody assay was positive since the first weeks of disease, and elevated levels were also fond many months after disease onset. When clinicians face patients with prominent swelling of lymph nodes draining from the upper limbs, cat-scratch disease may be suspected on the grounds of epidemiological and clinical features, with a limited systemic involvement contrasting with a prominent local disease. The significance of specific antibody temporal kinetics in the subacute disease course is still unknown. Although biomolecular assays are now available, the time elapsed from disease onset to clinical diagnosis usually hampers diagnosis, while the roles of surgical debridement and of the unpredictable activity of antimicrobial chemotherapy warrant careful investigation.
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spelling Bartonellosis: suggestive case reports in adult and pediatric patients and therapeutic issuesAdultsantimicrobial chemotherapyBartonellosisBartonella henselaecase reportschildrenclinical presentationoutcometreatmentCat-scratch disease warrants extensive investigation, from an epidemiological, a diagnostic, but especially a therapeutic point of view. Two suggestive episodes of Bartonella henselae-caused cat-scratch disease are reported, and discussed in the light of the most recent literature evidence. The first case occurred in a 60-year-old man, thus suggesting that it is important to maintain an elevated level of suspicion for this disease in adults as well. Both episodes were characterized by a very prolonged and complicated disease course (with the involvement of three lymph node sets in the first case), a need for lymph-node drainage, and apparently negligible activity of many antimicrobial courses, with a very slow local cure. While specific culture and molecular biology techniques proved negative (probably due to late availability of appropriate clinical specimens), indirect immunofluorescence antibody assay was positive since the first weeks of disease, and elevated levels were also fond many months after disease onset. When clinicians face patients with prominent swelling of lymph nodes draining from the upper limbs, cat-scratch disease may be suspected on the grounds of epidemiological and clinical features, with a limited systemic involvement contrasting with a prominent local disease. The significance of specific antibody temporal kinetics in the subacute disease course is still unknown. Although biomolecular assays are now available, the time elapsed from disease onset to clinical diagnosis usually hampers diagnosis, while the roles of surgical debridement and of the unpredictable activity of antimicrobial chemotherapy warrant careful investigation.Brazilian Society of Infectious Diseases2006-12-01info:eu-repo/semantics/reportinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702006000600012Brazilian Journal of Infectious Diseases v.10 n.6 2006reponame:Brazilian Journal of Infectious Diseasesinstname:Brazilian Society of Infectious Diseases (BSID)instacron:BSID10.1590/S1413-86702006000600012info:eu-repo/semantics/openAccessManfredi,RobertoSabbatani,Sergioeng2007-03-30T00:00:00Zoai:scielo:S1413-86702006000600012Revistahttps://www.bjid.org.br/https://old.scielo.br/oai/scielo-oai.phpbjid@bjid.org.br||lgoldani@ufrgs.br1678-43911413-8670opendoar:2007-03-30T00:00Brazilian Journal of Infectious Diseases - Brazilian Society of Infectious Diseases (BSID)false
dc.title.none.fl_str_mv Bartonellosis: suggestive case reports in adult and pediatric patients and therapeutic issues
title Bartonellosis: suggestive case reports in adult and pediatric patients and therapeutic issues
spellingShingle Bartonellosis: suggestive case reports in adult and pediatric patients and therapeutic issues
Manfredi,Roberto
Adults
antimicrobial chemotherapy
Bartonellosis
Bartonella henselae
case reports
children
clinical presentation
outcome
treatment
title_short Bartonellosis: suggestive case reports in adult and pediatric patients and therapeutic issues
title_full Bartonellosis: suggestive case reports in adult and pediatric patients and therapeutic issues
title_fullStr Bartonellosis: suggestive case reports in adult and pediatric patients and therapeutic issues
title_full_unstemmed Bartonellosis: suggestive case reports in adult and pediatric patients and therapeutic issues
title_sort Bartonellosis: suggestive case reports in adult and pediatric patients and therapeutic issues
author Manfredi,Roberto
author_facet Manfredi,Roberto
Sabbatani,Sergio
author_role author
author2 Sabbatani,Sergio
author2_role author
dc.contributor.author.fl_str_mv Manfredi,Roberto
Sabbatani,Sergio
dc.subject.por.fl_str_mv Adults
antimicrobial chemotherapy
Bartonellosis
Bartonella henselae
case reports
children
clinical presentation
outcome
treatment
topic Adults
antimicrobial chemotherapy
Bartonellosis
Bartonella henselae
case reports
children
clinical presentation
outcome
treatment
description Cat-scratch disease warrants extensive investigation, from an epidemiological, a diagnostic, but especially a therapeutic point of view. Two suggestive episodes of Bartonella henselae-caused cat-scratch disease are reported, and discussed in the light of the most recent literature evidence. The first case occurred in a 60-year-old man, thus suggesting that it is important to maintain an elevated level of suspicion for this disease in adults as well. Both episodes were characterized by a very prolonged and complicated disease course (with the involvement of three lymph node sets in the first case), a need for lymph-node drainage, and apparently negligible activity of many antimicrobial courses, with a very slow local cure. While specific culture and molecular biology techniques proved negative (probably due to late availability of appropriate clinical specimens), indirect immunofluorescence antibody assay was positive since the first weeks of disease, and elevated levels were also fond many months after disease onset. When clinicians face patients with prominent swelling of lymph nodes draining from the upper limbs, cat-scratch disease may be suspected on the grounds of epidemiological and clinical features, with a limited systemic involvement contrasting with a prominent local disease. The significance of specific antibody temporal kinetics in the subacute disease course is still unknown. Although biomolecular assays are now available, the time elapsed from disease onset to clinical diagnosis usually hampers diagnosis, while the roles of surgical debridement and of the unpredictable activity of antimicrobial chemotherapy warrant careful investigation.
publishDate 2006
dc.date.none.fl_str_mv 2006-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/report
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format report
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702006000600012
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702006000600012
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/S1413-86702006000600012
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Brazilian Society of Infectious Diseases
publisher.none.fl_str_mv Brazilian Society of Infectious Diseases
dc.source.none.fl_str_mv Brazilian Journal of Infectious Diseases v.10 n.6 2006
reponame:Brazilian Journal of Infectious Diseases
instname:Brazilian Society of Infectious Diseases (BSID)
instacron:BSID
instname_str Brazilian Society of Infectious Diseases (BSID)
instacron_str BSID
institution BSID
reponame_str Brazilian Journal of Infectious Diseases
collection Brazilian Journal of Infectious Diseases
repository.name.fl_str_mv Brazilian Journal of Infectious Diseases - Brazilian Society of Infectious Diseases (BSID)
repository.mail.fl_str_mv bjid@bjid.org.br||lgoldani@ufrgs.br
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