Caracterización clínica y epidemiológica de la enfermedad por arañazo de gato en el Hospital de Niños Roberto Gilbert en el periodo enero 2014 a marzo 2025.

Abstract

Introduction: Cat-scratch disease (CSD) is a zoonosis caused by *Bartonella henselae*. Its typical clinical presentation involves regional lymphadenopathy and mild constitutional symptoms; however, a systemic presentation occurs in 5–20% of cases, making it part of the differential diagnosis for fever of unknown origin. Objectives: To determine the clinical and epidemiological characteristics of cat-scratch disease in pediatric patients and to identify differences between systemic and localized infections. Materials and Methods: This was a retrospective, descriptive, cross-sectional study. Statistical analysis was performed using R software (version 4.2), employing the chi-square test, p-values, and prevalence odds ratios (POR). Results: A total of 93 patients were included; 53.7% presented with lymph node involvement, and 46.2% presented with systemic involvement—characterized by Parinaud's syndrome, encephalitis, and hepatic and/or splenic abscesses. Statistically significant variables associated with the systemic form of CSD included prolonged fever (POR 3.991; 95% CI 1.3–12.19; p=0.04), elevated CRP (POR 9.89; 95% CI 3.45–28.29; p=1.553e-05), anemia (POR 3.76; 95% CI 1.58–8.95; p=0.0022), and thrombocytosis (POR 2.95; 95% CI 1.26–6.89; p=0.011). Azithromycin was the most frequently used treatment for the lymph node presentation, while the combination of trimethoprim-sulfamethoxazole and gentamicin was used for the systemic presentation. Conclusions: CSD affects both sexes equally and is most prevalent among school-aged children and during warmer months; the most frequent clinical features of systemic involvement are hepatosplenic abscesses. Prolonged fever, anemia, thrombocytosis, and elevated CRP are significant variables in the systemic form.