ISSN: 0022-1198
CODEN: JFSCA
Published Online: 1 May 2002
Page Count: 5

Fatal Meningitis and Encephalitis Due to Bartonella henselae Bacteria
Gerber, JE
Forensic Medical, TN

Johnson, JE
Vanderbilt University Medical Center, TN

Madhusudhan, KT
University of Arkansas for Medical Sciences, AR

Scott, MA
University of Arkansas for Medical Sciences, AR

(Received 24 October 2001; accepted 15 October 2001)

Abstract

Bacterial infection due to Bartonella henselae commonly develops in children and young adults following cat/dog ontacts and/or cat/dog scratches. Regional lymphadenopathy is its most common clinical expression. However, encephalitis and Parinaud's syndrome (oculoglandular syndrome) have also been reported as has systemic illness. A review of the international literature in all languages revealed no fatal complications in immunocompetent hosts. A four-year-old white child with no underlying illness began to have seizure-like activity. She was taken to a local hospital and subsequently transferred to a medical center. The child was treated aggressively for seizures and fever of unknown origin. However, her condition rapidly declined and she died without a specific diagnosis. At autopsy there was marked cerebral edema with no gross evidence of acute meningitis. Microscopic exams revealed multiple granulomatous lesions as well as a meningitis and encephalitis. A variety of cultures and stains were negative for acid fast and fungal organisms. Warthin-Starry stains of involved tissue including brain and liver revealed pleomorphic rod shaped bacilli consistent with Bartonella henselae. Analysis of brain tissue with polymerase chain reaction (PCR) and Southern blot for the deoxyribonucleic acid (DNA) was definitive for DNA of Bartonella henselae bacteria.

Keywords:
forensic science, meningitis, encephalitis, Bartonella henselae, deoxyribonucleic acid typing, polymerase chain, reaction, cat scratch, fatality

Paper ID: JFS15307J
DOI: 10.1520/JFS15307J
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