Encephalopathy of Cat-Scratch Disease

Cat-scratch disease was first postulated as an infectious granuloma, possibly tularemia, in 1932, when Debre and Foshay independently described this condition. 1 In 1947, Debre enhanced accuracy of diagnosis with a skin test utilizing an antigen prepared by Foshay. It was not until 1950, however, that cat-scratch disease was formally recognized as an entity, when Debre reported the first known case. 2 Since 1950, over 200 cases have been described in various parts of the world. The classical clinical picture is an initial skin lesion with regional adenopathy; however, mesenteric lymphadenitis, thrombocytopenic purpura, pulmonary infiltration, and erythema-nodosum-like lesions have occurred as rare complications. 3,4 An associated encephalopathy was first recorded by Stevens, 5 in 1952, and since this time, 14 cases of cat-scratch disease with neurologic symptoms have been reported. It is the purpose of this presentation to describe the findings in a child with cat-scratch disease who exhibited evidence