Cat Scratch Disease and Psychotic Illness: Exploring a Potential Link

Author(s): Syed Owais Akhtar, Muhammad Maqbool, Suriya Bala Shanmugar, Rubab Faisal, Taranpreet Singh, Shaoor Ahmed, Sania Mumtaz Kiyani, Eiman Zehra, Aliu Olalekan Olatunji, Saqib Muhammad

Cat scratch disease, a common bacterial infection caused by Bartonella henselae, typically presents mild, self-limiting symptoms. However, emerging evidence suggests a possible link between CSD and an increased risk of developing psychotic illnesses, such as schizophrenia. This narrative review examines the existing literature to explore this potential association. We discuss the epidemiology and pathogenesis of CSD, focusing on how Bartonella henselae can disseminate throughout the body and potentially impact the central nervous system. Potential mechanisms of neurotoxicity, including neuroinflammation, blood-brain barrier disruption, and molecular mimicry, are explored. We analyze serological studies and case reports that provide preliminary evidence for a connection between CSD and psychosis, while acknowledging the limitations of these studies in establishing causality. Furthermore, we broaden the scope to consider the concept of the "infectome" and the potential role of other infectious agents in mental illness. This review highlights the need for robust, longitudinal studies to clarify the relationship between CSD and psychotic disorders. Understanding this potential link has significant implications for public health awareness, preventive measures, and clinical vigilance in diagnosing and treating both CSD and psychotic illnesses.