• Pediatric emergency care · Nov 2016

    Case Reports

    Status Epilepticus Due to Cat Scratch Disease: Recognition, Diagnosis, and Thoughts on Pathogenesis.

    • Angel Lorrine Schuster, Travis C B Honeycutt, and Harvey James Hamrick.
    • From the *Department of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill; †Departments of Emergency Medicine and Pediatric Emergency Medicine; ‡Department of Pediatrics, Pediatric Critical Care, WakeMed Health and Hospitals, Raleigh, NC; and §Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC.
    • Pediatr Emerg Care. 2016 Nov 1; 32 (11): 789-791.

    AbstractDespite the publication of a number of case reports since the 1950s, physician awareness of the unique relationship between cat scratch disease (CSD) and acute encephalopathy remains limited. This report alerts emergency medicine physicians to include CSD encephalopathy (CSDE) in the differential diagnosis when a previously healthy child presents with status epilepticus. Prompt recognition of this relationship impacts the selection of initial diagnostic studies and antibiotic choices and permits reliable insight into prognosis. The 2 cases are from different eras and demonstrate the significant diagnostic advances in the past 3 decades for Bartonella henselae infection. Both children were treated with antibiotics, and both had resolution of all neurological symptoms. However, the role of antibiotics in the treatment and outcome of CSDE remains speculative. Lastly, the report suggests potential areas of investigation to address immune-mediated mechanisms in the pathogenesis of CSDE.

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