Hepatosplenic abscesses in an immunocompetent child with cat-scratch disease from Peru

Ann Clin Microbiol Antimicrob. 2019 Jul 15;18(1):23. doi: 10.1186/s12941-019-0322-0.

Abstract

Background: Cat-scratch disease (CSD) is a zoonotic infection caused by Bartonella henselae and B. clarridgeiae. The typical manifestations of CSD include regional lymphadenitis and fever. However, CSD can have a wide variety of clinical manifestations that can lead to incorrect diagnoses and prolonged hospital stays.

Case presentation: We present a case of a 3-year-old boy admitted to the pediatric service due to prolonged fever and abdominal pain. He received empirical antimicrobial treatment due to suspicion of infection. Abdominal ultrasound showed hepatosplenic abscesses. An IFA detected the presence of IgG antibodies against B. henselae (1:256). Patient was successfully treated with azithromycin and discharged after 7 weeks.

Conclusions: Hepatosplenic abscesses in CSD are rarely reported, particularly in immunocompetent children, with this, only 36 cases in PubMed, Web of Sciences and Scopus bibliographical databases. High rate of suspicion and serological tests availability are of utmost importance in order to detect it and treat it successfully and promptly.

Keywords: Bartonella henselae; Cat-scratch disease; Child; Hepatosplenic abscesses; Peru.

Publication types

  • Case Reports

MeSH terms

  • Abdomen / diagnostic imaging
  • Antibodies, Bacterial / blood*
  • Bartonella henselae / immunology*
  • Bartonella henselae / isolation & purification
  • Cat-Scratch Disease / diagnosis*
  • Cat-Scratch Disease / pathology*
  • Child, Preschool
  • Fluorescent Antibody Technique, Indirect
  • Humans
  • Immunoglobulin G / blood
  • Liver Abscess / etiology
  • Liver Abscess / pathology*
  • Male
  • Peru
  • Splenic Diseases / etiology
  • Splenic Diseases / pathology*
  • Ultrasonography

Substances

  • Antibodies, Bacterial
  • Immunoglobulin G