title: An unusual outcome in a child with hepatosplenic cat-scratch disease.
abstract: Typical cat-scratch disease (Bartonella henselae infection) in an immunocompetent child is usually associated with a history of scratch, bite or intimate contact with a cat. Most patients develop a non-tender papule in the scratch line after three to ten days. This may persist for only a few days or as long as two to three weeks. During the next two weeks or more, regional lymph nodes that drain the area gradually enlarge and then slowly resolve in more than 10% of patients. The nodes develop overlying erythema and may suppurate. Atypical forms of cat-scratch disease occur in a minority of cases and are characterized by ocular or neurological manifestations, hepatosplenic involvement, vertebral osteomyelitis, endocarditis etc. Immunocompromised individuals with B. henselae infection may develop bacillary angiomatosis, bacillary peliosis, and relapsing bacteremia. There have been several reports of hepatosplenic granulomas caused by B. henselae in immunocompetent children. We report a case of a 6-year-old boy with the hepatosplenic form of cat-scratch disease. Despite early diagnosis and long-term antimicrobial treatment, splenectomy could not be avoided.
authors.affiliation: University Hospital for Infectious Diseases Dr. Fran Mihaljević, Zagreb, Croatia. bfm@bfm.hr
authors.forename: Dalibor
authors.initials: D
authors.lastname: Vukelić
authors.forename: Branka
authors.initials: B
authors.lastname: Benić
authors.forename: Dragomir
authors.initials: D
authors.lastname: Bozinović
authors.forename: Branka
authors.initials: B
authors.lastname: Vuković
authors.forename: Oktavija
authors.initials: O
authors.lastname: Dakovic Rode
authors.forename: Zdravka
authors.initials: Z
authors.lastname: Culig
authors.forename: Jurica
authors.initials: J
authors.lastname: Vuković
authors.forename: Stipe
authors.initials: S
authors.lastname: Batinica
authors.forename: Stjepan
authors.initials: S
authors.lastname: Visnjić
authors.forename: Ivan
authors.initials: I
authors.lastname: Puljiz
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D001431:Bacteriological Techniques; D018416:Bartonella henselae / Q000276:immunology; D002372:Cat-Scratch Disease / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D002648:Child; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D006801:Humans; D010535:Laparoscopy; D008107:Liver Diseases / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D008297:Male; D016133:Polymerase Chain Reaction; D013154:Spleen / Q000473:pathology; D013158:Splenic Diseases / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D014463:Ultrasonography
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial