Bartonella henselae encephalopathy in a paediatric patient: A case report and treatment review

What is known and objectives Bartonella henselae is the etiologic agent of “cat scratch disease (CSD)”. We describe a case of atypical CSD in a paediatric patient and include a review of the antibiotic treatment for this disease. Case description A 2‐year‐old child, with convulsive status and loss of consciousness, was admitted to hospital. Several antiepileptics and antibiotics were prescribed due to suspected central nervous system infection. When serology revealed Bartonella henselae antibodies, targeted antibiotic therapy was initiated and symptoms improved. However, seizures reappeared days after finishing the treatment so antiepileptics and antibiotics were reintroduced. What is new and conclusion A wide variety of antibiotic regimens have been used for the treatment of atypical CSD in paediatric patients. This report includes the case of a paediatric patient diagnosed with atypical CSD who presented neurological manifestations, and for which a regimen consisting of azithromycin and rifampin was employed to achieve recovery. Although “cat scratch disease” (CSD) is generally considered a self‐limiting disease process, bartonellosis cases are often accompanied by serious sequelae. Current recommendations are based on anecdotal evidence from both paediatric and adult cases because no consensus on optimal treatment has been reached.