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Updated: Jul 18, 2026
12:23
Granulocyte-dependent Autoantibody-induced Skin Blistering
Published on: October 12, 2012
[Three children with systemic cat scratch disease]
I Murano1, H Yoshii, H Kurashige
1Department of Pediatrics, Yamaguchi Prefecture Central Hospital.
Summary
Cat scratch disease, caused by Bartonella henselae, can present without swollen lymph nodes, manifesting as prolonged fever and liver/spleen lesions. This highlights its potential as a cause of fever of unknown origin, especially in Japan.
Area of Science:
- Infectious Diseases
- Pediatrics
- Hepatology
Background:
- Cat scratch disease (CSD) is typically associated with regional lymphadenopathy.
- Bartonella henselae is the primary causative agent of CSD.
Observation:
- Three pediatric patients presented with atypical CSD, exhibiting prolonged fever and back pain without lymphadenopathy.
- Two patients developed hepatosplenic granulomas, including hypoechoic lesions in the liver and spleen.
- One patient required a partial left hepatic lobectomy for a significant hepatic lesion.
Findings:
- All patients demonstrated elevated antibodies to Bartonella henselae.
- Bartonella henselae DNA was confirmed via polymerase chain reaction in tissue from the patient who underwent surgery.
- These findings indicate systemic Bartonella henselae infection.
Implications:
- Cat scratch disease should be considered in the differential diagnosis of fever of unknown origin, particularly when lymphadenopathy is absent.
- The prevalence of Bartonella henselae infections may be underestimated in Japan.
- Early recognition and diagnosis are crucial for appropriate management of atypical CSD presentations.
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