International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
Cat scratch disease encephalitis: New insights into rate, clinical features, and long-term outcomes.
СтатьяНазвание и аннотация: Перевод в очереди
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Yakubovsky Michal, Kadar Laliv, Katchman Eugene, Regev Asaf, Atamna Alaa, Yelin Dana, Paul Mical, Finn Talya, Cohen Regev, Yahav Dafna, Megged Orli, Chazan Bibiana, Gottesman Giora, Moran-Gilad Jacob, Zimhony Oren, Grisaru-Soen Galia, Paran Yael, Ben-Ami Ronen, Gadoth Avi, Aizenstein Orna, Ephros Moshe, Gurevich Tanya, Giladi Michael
Аннотация
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.
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.