Cat scratch disease encephalitis: New insights into rate, clinical features, and long-term outcomes

Le résumé fourni par la source

OBJECTIVE: Encephalitis, is a rare manifestation of cat scratch disease (CSD). We aimed to characterize CSD encephalitis/meningoencephalitis rate, diagnosis, clinical features, and outcome. METHODS: Patients with encephalitis/meningoencephalitis were identified through a national CSD surveillance registry active since 1991. Clinical data were collected. Long-term follow-up was performed, including neurological/cognitive assessments. Outcome was assessed using the Extended Glasgow Outcome Scale (GOSE). RESULTS: Nineteen patients, 0.5% of the CSD cohort, were identified. Cat contact (84%), fever (79%), and lymphadenopathy (68%) were common. Seizures occurred in 13 patients (68%), including 5 with status epilepticus; 6 requiring mechanical ventilation. Two clinical patterns were identified: an acute form (63%), with rapid onset and shorter recovery, and a subacute form (37%), occurring in older patients (median age of 35 vs 12.5 years), with progressive neurologic manifestations and longer recovery. CSF findings varied. Neuroimaging was normal in 79%. All patients had favorable outcomes: 11 (58%) fully recovered (GOSE 8) while 8 (42%) reported persistent cognitive complaints (GOSE 7) after a median follow-up of 58 months, (range 1-185). CONCLUSION: CSD encephalitis/meningoencephalitis presents in two forms: acute and subacute. Prognosis is generally favorable, but recovery may take months and cognitive complaints often persist. Antibiotic and corticosteroid use warrants further investigation.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.