title: Cat-scratch disease presenting as a solitary splenic abscess in an elderly man.
abstract: Patients with cat-scratch disease (CSD), which is caused by Bartonella henselae, typically present with local lymphadenopathy with a brief period of fever and general symptoms. Most cases are self-limiting and usually afflict children and young adults. Although rare, CSD can lead to serious complications, especially in immunocompromised patients. These rare complications often require intensive treatment. We describe the case of a 79-year-old man who presented with general malaise and a high fever. The physical examination findings were unremarkable. Of note, the lymph nodes were not enlarged. An abdominal CT scan with intravenous contrast revealed a solitary splenic abscess and no lymphadenopathy. The initial antibiotic treatment was ineffective and a splenectomy was indicated. A history of contact with cats raised the possibility of CSD, which was confirmed by a positive serology test result for B henselae. Antibiotic treatment with azithromycin successfully treated the splenic abscess and splenectomy was avoided.
authors: Matsunami General Hospial, Hashima, Gifu, Japan.
authors: Momoko
authors: M
authors: Nakamura
authors: Matsunami General Hospial, Hashima, Gifu, Japan.
authors: Mio
authors: M
authors: Kurimoto
authors: Matsunami General Hospial, Hashima, Gifu, Japan.
authors: Takehiro
authors: T
authors: Kato
authors: Matsunami General Hospial, Hashima, Gifu, Japan.
authors: Takeshige
authors: T
authors: Kunieda
mesh_terms: D000038:Abscess / Q000188:drug therapy / Q000382:microbiology*; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017963:Azithromycin / Q000627:therapeutic use; D002372:Cat-Scratch Disease / Q000175:diagnosis* / Q000188:drug therapy; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D013158:Splenic Diseases / Q000188:drug therapy / Q000382:microbiology*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin