Adult systemic cat scratch disease associated with therapy for hepatitis C

BMC Infect Dis. 2007 Feb 23:7:8. doi: 10.1186/1471-2334-7-8.

Abstract

Background: We describe the first case of systemic cat scratch disease in a patient receiving peginterferon alpha-2a and ribavirin for treatment of hepatitis C. Cases of adult systemic CSD are extremely infrequent and immunomodulatory treatment for hepatitis C has been associated with aberrant host responses to common pathogens.

Case presentation: A 52 year old man being treated for hepatitis C presented with diffuse lymphadenopathy, weight loss, fevers and splenic lesions. Symptoms were initially confused with adverse effects of his regimen, delaying recognition of his infection. Diagnostic investigation, including histopathology, microbiology and serologic parameters, confirmed that his illness was due to disseminated cat scratch disease with Bartonella henselae.

Conclusion: Disseminated CSD is exceptionally rare in adults. We describe the first case of disseminated cat scratch disease associated with peginterferon alpha and ribavirin to alert clinicians of the need to be aware of unusual manifestations of common infections in this population.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Bartonella henselae / isolation & purification*
  • Cat-Scratch Disease / chemically induced
  • Cat-Scratch Disease / etiology*
  • Cat-Scratch Disease / immunology
  • Cat-Scratch Disease / microbiology
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / immunology
  • Humans
  • Interferon alpha-2
  • Interferon-alpha / adverse effects*
  • Interferon-alpha / therapeutic use
  • Male
  • Middle Aged
  • Polyethylene Glycols / adverse effects*
  • Polyethylene Glycols / therapeutic use
  • Recombinant Proteins
  • Ribavirin / adverse effects*
  • Ribavirin / therapeutic use

Substances

  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • Ribavirin
  • peginterferon alfa-2a