The Clinical Spectrum of Cat-Scratch Disease: Case Series from HKL

Cat-scratch disease (CSD), caused by Bartonella henselae, is traditionally regarded as a self-limiting illness and a common cause of necrotising granulomatous inflammation in Malaysia. However, diagnostic challenges persist, particularly due to the limited availability and low sensitivity of Warthin-Starry staining for detecting Bartonella species in tissue specimens. In response to these limitations, the Institute for Medical Research (IMR) has recently introduced molecular diagnostic testing for Bartonella spp. identification. This advancement has facilitated the diagnosis of several complex and atypical cases of Bartonella henselae infection, ranging from ophthalmic vasculitis and persistent lymphadenitis to infective endocarditis. This case series highlights the diverse clinical manifestations, diagnostic challenges, and importance of molecular tools in the accurate identification and management of Bartonella infections in Malaysia.