[A little known cause of persistent fever and granulomatous hepatitis in children: cat scratch disease].
BACKGROUND
Extensive hepatic and splenic involvement in cat-scratch disease has rarely been reported.


METHODS
A 2 1/2 year-old boy suffered for 2 weeks from high-grade fever, abdominal pain and alteration of his general condition. Ultrasonography revealed multiple hypoechogenic nodules in liver and spleen. The CT scan also showed hypodense lesions. An open liver biopsy was performed 5 weeks after the onset of illness. Histopathology of a resected nodule demonstrated neutrophilic granulomatous inflammation with central abscess formation. Recent cat exposure, suppurated epitrochlear lymph node 15 days before admission were also consistent with cat-scratch disease which was confirmed by elevated anti-Rochalimaea antibody titers. Follow-up showed complete resolution of all hepatic and splenic lesions within 6 months and emergence of splenic calcifications.


CONCLUSIONS
Cat-scratch disease should be considered in the diagnosis of fever of unknown origin and hepatosplenic abscesses in children.
Vanlemmens
P
P
Service des maladies infectieuses et tropicales, CHU Saint-Jacques, Besançon, France.
Leroy
J
J
Estavoyer
J M
JM
Destuynder
O
O
Aubert
D
D
Viennet
G
G
Colin
P
P
D002372:Cat-Scratch Disease / Q000150:complications* / Q000473:pathology; D002675:Child, Preschool; D005334:Fever / Q000209:etiology*; D006105:Granulomatous Disease, Chronic / Q000209:etiology* / Q000473:pathology; D006505:Hepatitis / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male
Une cause peu connue de fièvre prolongée et d'hépatite granulomateuse chez l'enfant: la maladie des griffes du chat.