Doctors were initially baffled by the case of a 23-year-old man who was suffering erectile dysfunction, high fever, intense night sweats, pain in the lower back, pelvis, testicles and penis glands. He had lost about 10kg over six months without any change to his diet or exercise regime.
With no medical history and assurances he had not engaged in unprotected sex, doctors began a battery of tests to rule out everything from STIs to cancer.
The patient's blood and urine examinations returned normal results, but doctors noted swollen lymph nodes in the area between his arms and shoulders. Stage IV lymphoma was considered, but tests of bone marrow and a biopsy didn't confirm the presence of cancer. He tested negative for HIV, Hepatitis and syphilis.
However, he tested positive for anti-Bartonella, and a surgical procedure revealed that the man's glands in the shoulder region were inflamed. Both his bone marrow and lymph nodes tested positive for Bartonella henselae.
Bartonella henselae is a pathogen in the Bartonella genus, one of the most common bacterias in the world, and it is associated with the cat-scratch disease. The bacteria is transmitted through cat bites or scratches, and can also be tranferred to humans by dogs, fleas, ticks, body lice and sand flies.
In the end, the patient's painful erectile woes turned out to be caused by a simple scratch from a kitten that caused a common bacterial infection easily cleared up by a course of antibiotics.
In the case report published in The BMJ, doctors noted that the disease is responsible for numerous clinical presentations, including erectile dysfunction, and should therefore be ruled out before other treatments are considered.
The report notes that the case of erectile dysfunction was particularly interesting, as it occurred because the disease was quite advanced. The report pointed out that the severity of an infection depends in part on each patient's immune system.
In the case discussed here, it is possible that the infection reached the patient's nervous system, thus leading to erectile disorder and testicular pain. Pain would logically prevent an erection from taking place. Even when the man was willing and suffered lighter symptoms, he would remain impotent.
Both the erectile disorders and testicular pain were resolved after a three-week antibiotic treatment.
There are about 22,000 to 24,000 confirmed cases of cat-scratch disease in the United States each year. In the most extreme cases, it can even lead to death. So beware next time you are cuddling a kitten as it could possibly kill you, or seriously affect your sex life.