title: Regional lymphadenopathy in cat-scratch disease: ultrasonographic findings.
abstract: BACKGROUND
  Cat-scratch disease (CSD) is considered to be an emerging disease worldwide and is caused by Bartonella henselae, a gram-negative bacterium introduced by a scratch or bite of a cat. The most common clinical manifestation is regional lymphadenopathy, but clinical recognition may be difficult, as atypical manifestations may occur. The diagnosis is confirmed with serologic testing and histology is rarely needed. This paper is based on our experience with the use of ultrasonography in the diagnosis of CSD.
  
  
  OBJECTIVE
  The aim of this study was to describe the sonographic and color Doppler appearances of regional lymphadenopathy in CSD, as this has not widely reported in the literature.
  
  
  METHODS
  Forty-seven patients (average 9.4 years) were included who all had serologically and/or histologically proven CSD and had been studied using US early in the clinical course. All had a positive history of exposure to cats and exhibited regional lymphadenopathy.
  
  
  RESULTS
  US showed large hypoechoic adenopathy with some transmission enhancement and high vascularization on color-flow Doppler imaging. In 30 patients, abdominal US was also performed and splenic and/or hepatic granulomata were found in 10.
  
  
  CONCLUSIONS
  In our experience, sonography and especially color-Doppler and power-Doppler sonography was helpful in the diagnosis of CSD. We believe it should be used in the initial study of children with regional lymphadenopathy, and serologic testing should be performed when CSD is suspected.
authors.affiliation: Departamento de Radiología, Hospital Clínico Universidad Católica, Santiago, Chile. famgarc@entelchile.net
authors.forename: C J
authors.initials: CJ
authors.lastname: García
authors.forename: C
authors.initials: C
authors.lastname: Varela
authors.forename: K
authors.initials: K
authors.lastname: Abarca
authors.forename: M
authors.initials: M
authors.lastname: Ferrés
authors.forename: P
authors.initials: P
authors.lastname: Prado
authors.forename: P A
authors.initials: PA
authors.lastname: Vial
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D018416:Bartonella henselae; D002372:Cat-Scratch Disease / Q000175:diagnosis / Q000000981:diagnostic imaging*; D002415:Cats; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D013997:Time Factors; D018615:Ultrasonography, Doppler, Color