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| Case of Cat Scratch Disease | |||||
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A five year old girl had fever, nausea, abdominal, and muscle pain. Her physical examination, blood and urine culture, and abdominal ultrasound were normal. She was treated for possible Kawasaki Disease. During her treatment her ESR went up to 121 mm/hour to 135 mm/hour. A second ultrasound showed an abnormal liver which lead to liver biopsy. The result of the biopsy showed necrotic and granulomatous tissue. Since the child had history of being scratched by a cat plus the biopsy finding consistent with this condition, her final diagnosis was Cat Scratch Disease. Reference: Year Book of Pediatrics, 1996, page 83 Comment: Children with fever longer than 5 days with abdominal pain should have a blood test for Cat Scratch called B. henselae titer. The reason is to avoid more testings if it is positive. I had one patient, boy, about 6 years old, who had lump at the left armpit. He did not have fever or other symptoms. I tested him for B. henselae and it was positive. He had Cat Scratch Disease. Leo Leonidas, MD, FAAP |
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