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Case Reports in Pediatrics
Volume 2014, Article ID 397437, 4 pages
http://dx.doi.org/10.1155/2014/397437
Case Report

Atypical Presentation of Cat-Scratch Disease in an Immunocompetent Child with Serological and Pathological Evidence

1Department of Pediatrics and Division of Pediatric Infectious Diseases, Marmara University Medical Faculty, Pendik Training and Research Hospital, Fevzi Cakmak Mah. Mimar Sinan Cad., Ust Kaynarca, Pendik, 34899 Istanbul, Turkey
2Department of Pathology, Marmara University Medical Faculty, Pendik Training and Research Hospital, Fevzi Cakmak Mah. Mimar Sinan Cad., Ust Kaynarca, Pendik, 34899 Istanbul, Turkey
3Marmara University Medical Faculty, Pendik Training and Research Hospital, Fevzi Cakmak Mah. Mimar Sinan Cad., Ust Kaynarca, Pendik, 34899 Istanbul, Turkey

Received 5 July 2014; Accepted 7 December 2014; Published 28 December 2014

Academic Editor: Bibhuti Das

Copyright © 2014 Serkan Atıcı et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Typical cat-scratch disease (CSD) is characterized by local lymphadenopathy following the scratch or bite from a cat or kitten. An atypical presentation which includes liver and/or spleen lesions is rarely reported in an immunocompetent child. Systemic CSD may mimic more serious disorders like malignancy or tuberculosis. Although a diagnosis is difficult to establish in systemic CSD, an early diagnosis and an appropriate treatment are important to prevent complications. Bartonella henselae is difficult to culture, and culture is not routinely recommended. Clinical, serological, radiological, and pathological findings are used for the diagnosis of CSD. Herein we present a case of systemic CSD presenting with hepatic mass in an immunocompetent child. The differential diagnosis is made by serological and pathological evidence. He was successfully treated with gentamicin (7.5 mg/kg) and rifampin (15 mg/kg) for six weeks.