Cat-Scratch Disease Presenting as Abdominal Visceral Granulomas

Three cases of atypical, clinically unsuspected cat-scratch disease (CSD), diagnosed by demonstration of the CSD bacillus in an abdominal visceral organ, are presented. In two cases CSD bacilli were demonstrated for the first time in splenic granulomas in a child and in an adult with acquired immuno...

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Bibliographic Details
Published in:The Journal of infectious diseases 1990-01, Vol.161 (1), p.71-78
Main Authors: Delahoussaye, Peggy M., Osborne, Barbara M.
Format: Article
Language:English
Subjects:
Adult
AIDS
AIDS/HIV
Bacillus
Bacterial adenopathies
Bacterial diseases
Biological and medical sciences
Biopsies
Biopsy
Cat scratch fever
Cat-Scratch Disease - complications
Cat-Scratch Disease - pathology
Child
Children
Granuloma
Granuloma - complications
Granuloma - etiology
Hepatitis
HIV Infections - complications
Human bacterial diseases
Humans
Infectious diseases
Laparotomy
Liver
Liver Diseases - diagnosis
Lymph nodes
Major Articles
Male
Medical sciences
Middle Aged
Spleen
Splenic Diseases - diagnosis
Staining and Labeling
Viscera - microbiology
Viscera - pathology
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Summary:Three cases of atypical, clinically unsuspected cat-scratch disease (CSD), diagnosed by demonstration of the CSD bacillus in an abdominal visceral organ, are presented. In two cases CSD bacilli were demonstrated for the first time in splenic granulomas in a child and in an adult with acquired immunodeficiency syndrome (AIDS)-related complex. In both cases, there was granulomatous hepatitis as well as splenitis. In the third case, the CSD bacillus was present in hepatic granulomas in an adult with granulomatous hepatitis. In all cases, granulomatous inflammation with suppuration in the viscera was identical to that previously described for lymph nodes in CSD. All patients eventually recovered completely. Clinical awareness of the broad spectrum ofCSD should avoid the cost and morbidity of prolonged hospitalization, medications, and invasive surgery for a disease that is self-limited and not clearly responsive to antibiotics and that can usually be diagnosed by noninvasive means.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/161.1.71