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Cat Scratch Meningoencephalitis


Presentation

  • Alistair Clarke 1, Angela Mcbride 2, Michael Kelsey 2, Ben Killingley 2 1 General Medicine, Whittington Health NHS Trust, London, UK 2 Whittington Health NHS Trust, London, UK Correspondence to Dr David Alistair Clarke, david.clarke11{at}nhs.net Summary We present[casereports.bmj.com]
  • Improve your interpretation of presenting symptoms with 38 new topics and 40 new images in the Differential Diagnosis section, and optimize patient care with more than 250 new figures and tables.[books.google.de]
  • Respiratory symptoms such as cough and haemoptysis may not be present.[explainmedicine.com]
  • Patients present with unilateral or bilateral acute visual loss.[patient.info]
Fever
  • She deteriorated in the Emergency Department—developing high fever, worsening confusion and meningism. Blood cultures were taken and broad spectrum antibiotics commenced prior to CT scanning and diagnostic lumbar puncture.[casereports.bmj.com]
  • […] symptoms of cat scratch fever include: loss of appetite weight loss sore throat Rare symptoms of cat scratch fever may be linked to a more severe version of the disease.[healthline.com]
  • ; extremely swollen lymph nodes; severe pneumonia; septicemia Q Fever dogs, cats 1-3 weeks typically asymptomatic Rocky Mountain Spotted Fever dogs 2-14 days fever; anorexia; depression; lymphadenopathy; dyspnea; diarrhea; vomiting; joint or muscle pain[borrettanimalhospital.com]
  • Fever Giphy As the name "cat-scratch fever" implies, CDS often features an elevated temperature in patients. Though of course there are many, many other reasons you have a fever, a cat could be to blame. 4.[bustle.com]
  • Tick-borne Rickettsia rickettsii Rocky Mountain spotted fever Rickettsia conorii Boutonneuse fever Rickettsia japonica Japanese spotted fever Rickettsia sibirica North Asian tick typhus Rickettsia australis Queensland tick typhus Rickettsia honei Flinders[en.wikipedia.org]
Cat Scratch
  • Pasteurella multocida meningoencephalitis in an immunocompetent adult with multiple cat scratches David Alistair Clarke 1, Angela Mcbride 2, Michael Kelsey 2, Ben Killingley 2 1 General Medicine, Whittington Health NHS Trust, London, UK 2 Whittington[casereports.bmj.com]
  • Cat scratch disease Other names Cat-scratch fever, Teeny's disease, inoculation lymphoreticulosis, subacute regional lymphadenitis [1] An enlarged lymph node in the armpit region of a person with cat-scratch disease, and wounds from a cat scratch on the[en.wikipedia.org]
  • You can’t get cat scratch disease from another human. Anyone who owns or interacts with a cat is at risk of contracting cat scratch fever.[healthline.com]
  • Cat-scratch fever, also known simply as "cat-scratch disease" (CDS), is a bacterial infection that cats catch from each other via infected fleas.[bustle.com]
  • Cat-Scratch Disease Definition Cat-scratch disease is an uncommon infection that typically results from a cat's scratch or bite.[medical-dictionary.thefreedictionary.com]
Failure to Thrive
  • Fred Ferri’s popular "5 books in 1" format provides quick guidance on menorrhagia, Failure to Thrive (FTT), Cogan’s syndrome, and much more.[books.google.de]
Photophobia
  • The aforementioned features of encephalitis, ADEM and AHLE distinguish patients with encephalitis from those with meningitis in whom abrupt onset of fever, headache, photophobia, nuchal rigidity and other meningeal signs predominate.[academic.oup.com]
Suggestibility
  • Access full-color images and more than 90 online-only topics at Expert Consult, as well as EBMs, Suggested Reading, Patient Teaching Guides, and additional algorithms.[books.google.de]
  • There was some research published that suggested a possible link with Crohn's disease. This work was rejected by the WHO and by many other scientists in the field. There were also suggestions of a possible link with autism.[netdoctor.co.uk]
  • The optimal length for this treatment has yet to be determined, but guidelines suggest at least four to six weeks.[columbia-lyme.org]
  • In conjunction with a compatible medical history, an IgG titer 1:50 to B. henselae suggests a diagnosis of acute infections such as cat scratch disease (CSD), while IgG 1:800 to either B. henselae or B. quintana suggests a diagnosis of endocarditis [[bmcinfectdis.biomedcentral.com]
Seizure
  • Symptoms and Types Neurological symptoms often associated with meningitis, meningoencephalitis, and meningomyelitis such as impaired movement, altered mental state, and seizures, may be profound and progressive.[petmd.com]
  • The importance of recognizing and treating continuous seizures and increased intracranial pressure cannot be overemphasized.[academic.oup.com]
  • In the most severe cases, seizures * and loss of consciousness may occur.[humanillnesses.com]
  • CSD lymphadenopathy had been diagnosed in both children approximately 3 weeks before the onsets of seizure and coma.[wonder.cdc.gov]
Neck Stiffness
  • Neck stiffness. Sleepiness or lethargy. Increased irritability. Seizures. Skin rashes. Difficulty talking and speech changes. Changes in alertness, confusion, or hallucinations.[chw.org]
  • The first signs may be a severe headache and neck stiffness followed by fever, vomiting, a rash, and, then, convulsions leading to loss of consciousness.[encyclopedia.com]

Workup

Pericardial Effusion
  • effusions; hemorrhagic syndrome less common; overall mortality rate 1% in endemic areas; case fatality rate 20% among hospitalized patients Louping ill (Ovine encephalomyelitis, see Louping Ill ) Louping ill virus (family Flaviviridae, genus Flavivirus[merckvetmanual.com]

Treatment

  • New treatment investigated for brain tapeworm infection Nov 30, 2017 Pretreatment with the anti-tumor necrosis factor drug a viable strategy to manage post-treatment inflammatory response seen with neurocysticercosis treatment.[medlink.com]
  • The dog did not respond to treatment and a post mortem confirmed that it was suffering from granulomatous meningoencephalitis (GME).[canadawestvets.com]
  • Treatment: There is no specific treatment for other viral causes and the emphasis of treatment is supportive. Intravenous broad-spectrum antibiotics may be given to treat secondary bacterial infections.[medigoo.com]
  • Treatment If a bite or scratch occurs, prompt first aid treatment is necessary followed by medical treatment. First aid treatment should include cleansing with an antibacterial detergent and irrigation with large amounts of water.[health24.com]
  • Treatment with antibiotics and anticonvulsants can be effective providing that the meningoencephalitis is the result of a tick-borne virus. 7.[vetinfo.com]

Prognosis

  • Other animals, such as those suffering from distemper, FIP, cryptococcosis, GME or the breed-specific disorders have a somewhat more guarded prognosis. The main complication is progression of neurological disease despite treatment.[canadawestvets.com]
  • The prognosis depends on the age of the patient and the underlying aetiology. The poorest prognosis for meningoencephalitis occurs in patients with HSV encephalitis and subacute sclerosing panencephalitis. Symptoms: Symptoms include: Headaches.[medigoo.com]
  • In addition, even experienced physicians often are uncertain about the cause, appropriate therapy, and prognosis.[pedsinreview.aappublications.org]
  • Their prognosis is much more guarded.[bronberger.co.za]
  • Prognosis [ 1 ] Complete recovery is usual in 2-5 months. Rarely, there is severe hepatic or neurological involvement, in which case granulomatous hepatitis, neuroretinitis and peripheral neuritis can occur.[patient.info]

Etiology

  • A thorough and accurate review is difficult because the syndrome is complex and the number of etiologic agents and mimics of encephalitis are vast.[pedsinreview.aappublications.org]
  • ETIOLOGICAL AGENTS A list of many of the possible etiological agents, their clinical clues and recommended tests are provided in Tables 2 to 4 .[academic.oup.com]
  • Serological tests for other etiologies were negative.[ncbi.nlm.nih.gov]
  • Debre postulated tularemia, pasteurellosis, infectious mononucleosis, or tuberculosis as possible etiologic agents, but with no convincing proof.[emedicine.medscape.com]
  • ETIOLOGIC DIAGNOSIS: Bartonella lymphadenitis CAUSE: Bartonella henselae CONDITION: Cat scratch disease (CSD) GENERAL DISCUSSION: · Bartonella henselae (previously Rochalimaea henselae ) is a gram-negative, argyrophilic, intraerythrocytic bacillus which[askjpc.org]

Epidemiology

  • […] laboratory and epidemiologic studies are being conducted.[wonder.cdc.gov]
  • ., similar disease manifestations as in human patients have been observed and thus dogs represent epidemiological sentinels for human exposure. However, the role of dogs as a source of human infection is less clear than it is for cats.[cvbd.org]
  • Clinicians should consider CSD as a differential diagnosis when assessing previously healthy patients with aseptic meningitis associated with regional lymphadenopathy and epidemiological history of feline contact. [Indexed for MEDLINE] Free full text[ncbi.nlm.nih.gov]
  • Epidemiology 14. EPIDEMIOLOGY  Worldwide distribution Prevalence in warm/humid climates  20,000 cases annually in US 80% under the age of 20yrs  30% of domestic cats are infected 15.[slideshare.net]
  • Infection may occur without any epidemiological evidence of animal contact. How can you recognise the disease in humans? The first signs will develop at the wound site, 12 to 72 hours after the bite or scratch.[health24.com]
Sex distribution
Age distribution

Pathophysiology

  • The internationally acclaimed "gold standard" offers unparalleled coverage of pathophysiology, diagnosis, and treatment of diseases affecting dogs and cats, as well as the latest information on the genome, clinical genomics, euthanasia, innocent heart[books.google.de]
  • View Article PubMed PubMed Central Google Scholar Raoult D, Marrie T, Mege J: Natural history and pathophysiology of Q fever. Lancet Infect Dis. 2005, 5: 219-226. 10.1016/S1473-3099(05)70052-9.[bmcinfectdis.biomedcentral.com]
  • " Pathophysiology Most cases of CSD are caused by Bartonella henselae. Bartonella species are small pleomorphic, fastidious, facultative, gram-negative, and intracellular bacilli.[emedicine.medscape.com]
  • PATHOPHYSIOLOGY In general, meningoencephalitis and encephalitis represent uncommon responses to common infections. Most infected patients have a mild syndrome of meningoencephalitis rather than severe encephalitis ( 6 ).[academic.oup.com]

Prevention

  • Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets[books.google.de]
  • The best defense you can give your pet is to make sure he or she is current on flea, tick, and heartworm prevention and is screened at least yearly during a preventive care exam.[highwayvet.com]
  • How Is Encephalitis Prevented? Some of the viral infections that can cause encephalitis, including measles, mumps, and chicken pox, can be prevented with vaccines given in childhood.[humanillnesses.com]

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