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Intra-nodal injection of gentamicin for the treatment of suppurated cat scratch disease’s lymphadenitis

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Abstract

Purpose

Cat scratch disease (CSD)’s lymphadenitis may have a protracted course with painful suppuration necessitating several needle aspirations or surgical drainage. The objective of this study was to evaluate the benefit of an intra-nodal injection of gentamicin add-on oral azithromycin treatment on the outcome of suppurated CSD’s lymphadenitis.

Methods

We performed a retrospective monocentric study including 51 consecutive patients diagnosed between Jan 2009 and Mar 2014 with suppurated CSD who had a positive PCR for Bartonella henselae DNA in pus collected from lymph node by needle aspiration, and who were treated with azithromycin.

Results

Among them, 26/51 patients (51 %) received oral azithromycin only, of whom 8 patients (31 %) were cured and 18 patients (69 %) had complications, while 25/51 patients (49 %) received an intra-nodal injection of gentamicin add-on oral azithromycin, of whom 16 patients (64 %) were cured and 9 patients (36 %) had complications. In univariate analysis, the combined treatment was the only variable related to cure without complications (64 versus 31 %, p = 0.01), but this difference did not remain statistically significant in multivariate analysis (OR = 3.84, 95 % CI: 0.95–15.56, p = 0.06).

Conclusions

Intra-nodal injection of gentamicin add-on oral azithromycin treatment might improve the outcome of patients with suppurated CSD’s lymphadenitis, deserving further randomized studies.

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Abbreviations

CSD:

Cat scratch disease

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Infectious and Tropical Diseases, Toulouse University Hospital, Place du Docteur Baylac TSA 40031, 31059, Toulouse Cedex 9, France

    Camille Garnier, Guillaume Martin-Blondel, Alexa Debard, Lise Cuzin, Patrice Massip, Pierre Delobel & Bruno Marchou

  2. INSERM U1043-CNRS UMR 5282, Centre de Physiopathologie Toulouse-Purpan, Toulouse, France

    Guillaume Martin-Blondel, Damien Dubois & Pierre Delobel

  3. Université Toulouse III, 31000, Toulouse, France

    Guillaume Martin-Blondel, Patrice Massip, Pierre Delobel & Bruno Marchou

  4. Department of Paediatrics, Toulouse University Hospital, Toulouse, France

    Cécile Debuisson

  5. Department of Bacteriology, Toulouse University Hospital, Toulouse, France

    Damien Dubois

Authors
  1. Camille Garnier
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  2. Guillaume Martin-Blondel
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  3. Cécile Debuisson
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  4. Damien Dubois
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  5. Alexa Debard
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  6. Lise Cuzin
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  7. Patrice Massip
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  8. Pierre Delobel
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  9. Bruno Marchou
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Corresponding author

Correspondence to Guillaume Martin-Blondel.

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Garnier, C., Martin-Blondel, G., Debuisson, C. et al. Intra-nodal injection of gentamicin for the treatment of suppurated cat scratch disease’s lymphadenitis. Infection 44, 23–27 (2016). https://doi.org/10.1007/s15010-015-0797-3

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  • DOI: https://doi.org/10.1007/s15010-015-0797-3

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