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CAT-SCRATCH DISEASE.

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Anti-Bacterial Agents↗

[A case report of cat scratch disease which mimicked a metastasis of lung cancer].

A 67-year-old woman to our hospital because of the swelling of lymph nodes in the right inguinal region. Eighteen months before, right lower lobectomy was performed for primary lung cancer (papillary adenocarcinoma). In September 1986, she noticed the swelling of lymph no does in the right inguinal region and low grade fever. At first she was suspected to have a metastasis of the lung cancer. Lymph node biopsy was performed. The pathological examination revealed purulent lymphadenitis with granulomatous change, and Gram-negative Warthin Starry stain positive rods were found. In addition, she admitted a history of keeping cats fourteen years. Therefore the diagnosis of cat scratch disease was made. Six months later, she became free of the associated symptoms. We feel pathological confirmation of suspicious lymph nodes is important in the treatment of patients with history of malignancy.

Adenocarcinoma, Papillary↗

Cat scratch disease mimicking Richter's Syndrome in a patient with chronic lymphocytic leukemia.

Richter's Syndrome is a highly refractory and usually fatal condition. It occurs as a result of transformation of chronic lymphocytic leukemia (CLL) or low grade lymphoma into highly aggressive lymphoma. Patients usually present with rapidly enlarging lymph nodes and systemic symptoms like night sweats, fever and weight loss. We are reporting a case of CLL presenting with similar symptoms. Initial suspicion of Richter's Syndrome proved wrong when lymph node biopsy did not reveal evidence of high grade lymphoma. Instead it showed findings consistent with cat scratch disease (CSD), later confirmed by serology. To our knowledge this is the first reported case of CSD in a patient with CLL.

Cat-Scratch Disease↗

Visceral manifestation of cat scratch disease in children. A consequence of altered immunological state?

A 12-year-old girl with a 2-month history of fever and abdominal pain was admitted to our hospital. Ultrasound and CT scans of the abdomen showed multiple hypoechoic lesions of liver and spleen. Screening for zoonosis revealed high positive titers to Bartonella henselae. T-cell deficiency was demonstrated and remained almost unchanged during a follow-up of 11 months. A review of the literature shows that disseminated visceral affection is a rare presentation of cat scratch disease (CSD) in childhood and adolescence. Further immunological investigations are needed in more patients with CSD to confirm whether an altered immunological state may be responsible for the atypical visceral manifestation of CSD.

Animals↗