Cat scratch disease encephalitis: New insights into rate, clinical features, and long-term outcomes
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: Encephalitis, is a rare manifestation of cat scratch disease (CSD). We aimed to characterize CSD encephalitis/meningoencephalitis rate, diagnosis, clinical features, and outcome. METHODS: Patients with encephalitis/meningoencephalitis were identified through a national CSD surveillance registry active since 1991. Clinical data were collected. Long-term follow-up was performed, including neurological/cognitive assessments. Outcome was assessed using the Extended Glasgow Outcome Scale (GOSE). RESULTS: Nineteen patients, 0.5% of the CSD cohort, were identified. Cat contact (84%), fever (79%), and lymphadenopathy (68%) were common. Seizures occurred in 13 patients (68%), including 5 with status epilepticus; 6 requiring mechanical ventilation. Two clinical patterns were identified: an acute form (63%), with rapid onset and shorter recovery, and a subacute form (37%), occurring in older patients (median age of 35 vs 12.5 years), with progressive neurologic manifestations and longer recovery. CSF findings varied. Neuroimaging was normal in 79%. All patients had favorable outcomes: 11 (58%) fully recovered (GOSE 8) while 8 (42%) reported persistent cognitive complaints (GOSE 7) after a median follow-up of 58 months, (range 1-185). CONCLUSION: CSD encephalitis/meningoencephalitis presents in two forms: acute and subacute. Prognosis is generally favorable, but recovery may take months and cognitive complaints often persist. Antibiotic and corticosteroid use warrants further investigation.
Authors: Michal Yakubovsky, Laliv Kadar, Eugene Katchman, Asaf Regev, Alaa Atamna, Dana Yelin, Mical Paul, Talya Finn, Regev Cohen, Dafna Yahav, Orli Megged, Bibiana Chazan, Giora Gottesman, Jacob Moran-Gilad, Oren Zimhony, Galia Grisaru-Soen, Yael Paran, Ronen Ben-Ami, Avi Gadoth, Orna Aizenstein, Moshe Ephros, Tanya Gurevich, Michael Giladi
Institutions: Tel Aviv University, Tel Aviv Sourasky Medical Center, Kaplan Medical Center, Rabin Medical Center, Sheba Medical Center, Technion – Israel Institute of Technology, Rambam Health Care Campus, Laniado Hospital, Ariel University, Hillel Yaffe Medical Center, Hebrew University of Jerusalem, Shaare Zedek Medical Center, Bikur Cholim Hospital, Emek Medical Center, Clalit Health Services, Meir Medical Center, Ben-Gurion University of the Negev, Hadassah Medical Center
Language: English
Subfield: Parasitology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $2,900
OpenAlex ID: W7124245589