title: Cat scratch disease and lymph node tuberculosis in a colon patient with cancer.
abstract: A 71-year-old man operated for a sigmoid tumour remained in the surveillance after adjuvant chemotherapy. After 3 years, a left axillary lymph node was visible on CT scan. The biopsy revealed a necrotising and abscessed granulomatous lymphadenitis, suggestive of cat scratch disease. The patient confirmed having been scratched by a cat and the serology for Bartonella henselae was IgM+/IgG-. Direct and culture examinations for tuberculosis were negative. The patient was treated for cat scratch disease. One year later, the CT scan showed increased left axillary lymph nodes and a left pleural effusion. Direct and cultural examinations to exclude tuberculosis were again negative. Interferon-γ release assay testing for tuberculosis was undetermined and then positive. Lymph node and pleural tuberculosis were diagnosed and treated with a good radiological response. This article has provides evidence of the importance of continued search for the right diagnosis and that two diagnoses can happen in the same patient.
authors: Oncology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisboa, Portugal.
authors: M
authors: M
authors: Matias
authors: T
authors: T
authors: Marques
authors: M A
authors: MA
authors: Ferreira
authors: L
authors: L
authors: Ribeiro
mesh_terms: D000368:Aged; D018416:Bartonella henselae; D002372:Cat-Scratch Disease / Q000150:complications*; D006801:Humans; D061705:Image-Guided Biopsy; D008297:Male; D049268:Positron-Emission Tomography; D011183:Postoperative Complications / Q000209:etiology; D012811:Sigmoid Neoplasms / Q000150:complications* / Q000628:therapy; D014057:Tomography, X-Ray Computed; D014388:Tuberculosis, Lymph Node / Q000150:complications* / Q000175:diagnosis; D014396:Tuberculosis, Pleural / Q000150:complications* / Q000175:diagnosis