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Yale J Biol Med. 2010 Jun;83(2):67-71.

Expressive aphasia as a presentation of encephalitis with Bartonella henselae infection in an immunocompetent adult.

Author information

  • 1Departments of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06511, USA. carla.marienfeld@yale.edu

Abstract

OBJECTIVE:

To show the first clinically reported case of Cat Scratch Disease (CSD) presenting as a focal neurologic deficit in an immunocompetent adult.

PATIENT:

59-year-old male with a history of a previous stroke.

RESULTS:

Examination showed an expressive aphasia, word substitution errors, and impaired repetition. A head CT and MRI showed no acute changes. The EEG findings were non-focal and did not show any epileptiform activity. The patient had a history of contact with stray kittens and previous axillary lymphadenopathy. Bartonella henselae serology titers were IgG positive 1:1024 (< 64) and IgM positive 1:20 (< 16). After antibiotic administration, the patient's symptoms and aphasia resolved.

CONCLUSIONS:

Focal presentations concerning for stroke or partial seizure activity may have underlying infectious etiology. We recommend consideration of CSD in the differential diagnosis of any adult with a history of lymphadenopathy, fever, and recent contact with a cat who presents with neurologic complications.

KEYWORDS:

Bartonella henselae; antibiotics; encephalopathy; expressive aphasia; neurologic complications

PMID:
20589186
[PubMed - indexed for MEDLINE]
PMCID:
PMC2892771
Free PMC Article
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