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A careful review of the history with the mother showed that her son was scratched by a kitten about a month ago. His ESR was elevated to 95 mm/hr. The CBC was normal. His CT of the belly showed several small, hypodense areas in the liver and spleen. His blood test for Cat Scratch Disease (CSD) was positive. CSD is caused by a slow growing bacteria called Bartonella henselae. Some of its manifestations are enlarged lymph nodes at the armpit, neck, and chest wall with or without symptoms. Prolonged fever, belly pain, seizure, and coma has been reported in children wsith CSD. In about 10% of children with CSD there will be abscess of the spleen and liver. These symptoms can occur about one to seven weeks after being scratched by a kitten. Some children with CSD will get better without any treatment. Others will require antibiotics such as rifampin, erythromycin, clarithromycin, azithromycin, doxycycline, ciprolfoxacin, and gentamicin. Reference: Contemporary Pediatrics, July 2003, page 24 Leo Leonidas, MD, FAAP
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