title: Multiple Renal and Splenic Lesions in Cat Scratch Disease.
abstract: Cat scratch disease (CSD) is an infectious disease caused by Bartonella henselae. Atypical clinical presentations of CSD include prolonged fever and multiple hepatosplenic lesions. Furthermore, multiple renal lesions are extremely rare in CSD. An 11-year-old Japanese girl presented at our hospital with a prolonged fever of unknown cause after being scratched and bitten by a kitten. Abdominal computed tomography (CT) revealed multiple small, round hypodense lesions in both kidneys and the spleen. Based on her history and the CT results, her diagnosis was CSD. The diagnosis was confirmed by serological tests, which indicated antibodies against B. henselae. After treatment with azithromycin, her fever immediately improved. Careful history taking and imaging are essential for the diagnosis of atypical CSD. In CT images, not only hepatosplenic lesions but also renal lesions are important features indicative of a diagnosis of atypical CSD. Subsequently, a diagnosis of CSD can be confirmed by specific serological tests. This is the first reported Japanese case of multiple renal and splenic lesions in a patient with CSD. Although difficult to diagnose, an early diagnosis atypical CSD and appropriate treatment are important to prevent complications and the need for invasive examinations.
authors.affiliation: Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Wakiguchi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Manaka
authors.initials: M
authors.lastname: Matsunaga
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kodama
authors.forename: Akinori
authors.initials: A
authors.lastname: Miyazono
authors.forename: Shunji
authors.initials: S
authors.lastname: Seki
authors.forename: Naohiro
authors.initials: N
authors.lastname: Ikeda
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kawano
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D017963:Azithromycin / Q000627:therapeutic use; D018416:Bartonella henselae / Q000302:isolation & purification*; D001733:Bites and Stings / Q000150:complications; D002372:Cat-Scratch Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D002415:Cats; D002648:Child; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology*; D011860:Radiography, Abdominal; D012698:Serologic Tests; D013154:Spleen / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D017963:Azithromycin