Published online June 22, 2007
PEDIATRICS Vol. 119 No. 3 March 2007, pp. e760-e763 (doi:10.1542/peds.2006-1885)
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Cat-Scratch Disease (Bartonella...
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EXPERIENCE & REASON

Recurrent Expressive Aphasia as a Presentation of Cat-Scratch Encephalopathy

James W. Fox, MDa, Joanna K. Studley, MDb and Daniel M. Cohen, MDc

a Department of Pediatrics, Division of Emergency Medicine, Children’s Hospital of Akron, Akron, Ohio
b Department of Pediatrics
c Division of Emergency Medicine, Columbus Children’s Hospital, Columbus, Ohio

ABSTRACT

Cat-scratch disease is a common disease, occurring in an estimated 24000 patients annually in the United States, and is one of the most common causes of chronic lymphadenitis in children. A wide array of neurologic complications occurs as a result of cat-scratch disease. However, there have been no reports of acute-onset, self-resolving, recurrent, expressive aphasia, as we report here in an adolescent boy. In our case, establishing the diagnosis of cat-scratch encephalopathy saved time and resources and afforded the family a benign diagnosis. Cat-scratch encephalopathy must be considered in the differential diagnoses when pediatric patients present with unusual neurologic symptoms.

Key Words: cat-scratch disease • Bartonella henselae • expressive aphasia • encephalopathy • differential diagnosis

Abbreviations: CSD, cat-scratch disease • CNS, central nervous system • ED, emergency department

Accepted Oct 3, 2006.


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