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Chronic inflammatory demyelinating polyneuropathy as a complication of cat scratch disease
  1. PATRICIA M MCNEILL,
  2. AAD VERRIPS,
  3. REINIER A MULLAART,
  4. FONS J M GABREËLS
  1. Department of Pediatric Neurology, Neuromuscular Centre Nijmegen, University Hospital Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands
  2. Department of Neurology
  1. Dr A Verrips A.Verrips{at}ckskg.azn.nl
  1. ANNEKE W M GABREËLS-FESTEN,
  2. JAN G M KNIBBELER
  1. Department of Pediatric Neurology, Neuromuscular Centre Nijmegen, University Hospital Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands
  2. Department of Neurology
  1. Dr A Verrips A.Verrips{at}ckskg.azn.nl

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Cat scratch disease (CSD) was first described in 1950 as a benign regional lymphadenitis. This infection is caused byBartonella henselae. The clinical range of CSD has expanded beyond the classic presentation. In 5%–20% of the infected patients the disease may spread to other organs. However, neurological complications associated with CSD are rare, with encephalopathy being by far the most common form (90%) of nervous system involvement. Encephalopathy occurs in 2%–3% of patients and is more common in adults than in children with the onset varying from a few days to months after diagnosis of CSD.1 Other known neurological manifestations, often in combination with encephalopathy, are neuroretinitis, oculoglandular disease of Parinaud, myelopathy, radiculopathy or abducens nerve, and facial nerve paresis. We report on a 3 year old boy who developed chronic inflammatory demyelinating polyneuropathy (CIDP) 6 weeks after identification of CSD.

(A) Sural nerve. Low power electron micrograph. Demyelinated fibres (arrows) and thinly remyelinated fibres. Bar=2.0 μm. (B) Sural nerve; detail of myelinated fibre. Macrophage has invaded the myelinated fibre; process of macrophage is extending between axon and myelin sheath (arrow head). The damaged inner major dense line is terminating as a small dark swelling …

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