title: Prolonged follow up of seven patients affected by hepatosplenic granulomata due to cat-scratch disease.
abstract: This study is a retrospective analysis of seven patients with hypoechogenic lesions in the liver and/or spleen due to Bartonella henselae, who were followed from 1998 through to 2005 by the Department of Pediatrics, Turin University. In addition to showing constitutional symptoms, four children had skin lesions suggestive of injuries inflicted by cats, and one child had a history of exposure to cats. The origin of the infection remained undefined in the other two patients. Humoral tests enabled a precise diagnosis in all children. Treatment with macrolides or combinations of two active antibiotics for at least 2-3 weeks led to the definitive clearance of infection, although residual intraparenchymal lesions persisted in five patients for several months or years. Conclusion B. henselae serology allows an easy diagnosis of multiple hepatosplenic granulomata, a clinical picture that appears to be under-recognized. Macrolides or a combination of two active antibiotics for 2-3 weeks leads to a rapid clinical response and a definitive clearance of infection.
authors.affiliation: Department of Pediatrics, University of Turin, Piazza Polonia, 94, 10126, Turin, Italy. stefaniabezzio@hotmail.com
authors.forename: C
authors.initials: C
authors.lastname: Scolfaro
authors.forename: G G Kanga
authors.initials: GG
authors.lastname: Leunga
authors.forename: S
authors.initials: S
authors.lastname: Bezzio
authors.forename: N
authors.initials: N
authors.lastname: Chiapello
authors.forename: C
authors.initials: C
authors.lastname: Riva
authors.forename: L
authors.initials: L
authors.lastname: Balbo
authors.forename: C
authors.initials: C
authors.lastname: Bertaina
authors.forename: P-A
authors.initials: PA
authors.lastname: Tovo
mesh_terms: D000293:Adolescent; D018416:Bartonella henselae / Q000235:genetics / Q000302:isolation & purification; D001706:Biopsy; D002372:Cat-Scratch Disease / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000032:analysis; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006099:Granuloma / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000209:etiology*; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D013158:Splenic Diseases / Q000175:diagnosis / Q000209:etiology*; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D004269:DNA, Bacterial