Cat Scratch Disease in kidney transplant receptors: is it a rare or underdiagnosed pathology?

Cat Scratch Disease (CSD) is an infectious disorder which appears after cat scratching particularly in children and adolescents. Bartonella henselae is the etiologic agent more frequently involved. There are only a few recent reports demonstrating the disease after transplantation, although the illness is not infrequent in immunologically competent people. Indeed CSD in transplant receptors has only been recently emphasized in the literature and it was concluded that fever and lymphadenopathy in patients who had been exposed to cats should prompt clinicians to maintain a suspicion for the infection. In this report CSD infecting a renal transplanted adolescent complaining of headache, blurred vision and fever, presenting a cat scratching lesion in the right arm, with a bilateral painful cervical lymphadenopathy was related. He also presented indirect immunofluorescency identifying that the two subtype's titles of Bartonella-henselae and quintana- were elevated. Treatment with doxicicline e rifampicin was introduced and the patient became asymptomatic in about 3 weeks.

猫抓病（Cat Scratch Disease, CSD）是一种经猫抓挠后发病的感染性疾病，好发于儿童与青少年，其最常见的致病病原体为汉赛巴尔通体（Bartonella henselae）。尽管该疾病在免疫功能正常人群中并非罕见，但近年来关于移植术后罹患猫抓病的报道仍较为少见。事实上，移植受者相关的猫抓病直至近年才在文献中受到重视，相关研究指出：若曾接触猫的患者出现发热与淋巴结病症状，临床医师应警惕该感染的可能。本报告关联了1例肾移植术后青少年的猫抓病病例：该患者因头痛、视物模糊及发热就诊，右臂存在猫抓抓伤病灶，伴双侧疼痛性颈部淋巴结病；间接免疫荧光法（indirect immunofluorescency）检测显示，患者血清中汉赛巴尔通体与五日热巴尔通体（Bartonella quintana）的两种亚型抗体滴度均升高。予多西环素（doxycycline）联合利福平（rifampicin）治疗后，患者约3周内症状完全消失。