P620\u2005Disseminated bartonella henselae infection- case report

Abstract

Cat scratch disease is caused by Bartonella henselae- a fastidious gram-negative bacillus, and it has in most cases a self-limited evolution. However, it represents a challenge for diagnostic and treatment in immunosuppressed patients or in atypical and disseminated forms. We present the case of a 5-year-old immunocompetent child, who was admitted into the hospital for fever and left peri-auricular adenopathy. After 7 days of antibiotic treatment with beta-lactams, the fever was persistent, and diffuse abdominal pain was associated. An abdominal-CT scan examination was performed, which showed hypo-attenuated focal lesions in the splenic and hepatic parenchyma, with subsequent micro-calcifications. Thus, the patient was diagnosed with disseminated Bartonella henselae infection, and secondary hepatic and splenic micro-abscesses, based on the combination of the epidemiological, clinical, imaging and serological criteria. The clinical evolution was favorable after 6 weeks of antibiotic treatment with a macrolide (azithromycin) associated for 2 weeks with an aminoglycoside (gentamycin).