Cat-scratch disease resulting from Bartonella henselae infection
is usually a benign, self-limited process in immunocompetent
children. Even the rare cases associated with neurologic
manifestations are not generally fatal. We report a case of a
previously healthy 6-year-old boy with cat-scratch disease,
systemic dissemination, and encephalitis that led to his death.
Autopsy revealed perivascular lymphocytic infiltrates and
microglial nodules in the brain. To our knowledge, this finding
has not been previously reported in B. henselae infection,
possibly because of the paucity of material available for
complete neuropathologic evaluation. This case illustrates the
extreme severity of the spectrum with which cat-scratch disease
can present and provides evidence of brain histopathology that
may be representative of the disease.