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Multiple Renal and Splenic Lesions in Cat Scratch Disease
Hiroyuki Wakiguchi1, Yasuhiro Okamoto, Manaka Matsunaga
1Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences.
Japanese Journal of Infectious Diseases
|November 17, 2015
Summary
Cat scratch disease (CSD), caused by Bartonella henselae, can present atypically with kidney lesions. This case highlights multiple renal and splenic lesions in a Japanese child, emphasizing the importance of imaging for diagnosing CSD.
Area of Science:
- Infectious Diseases
- Pediatrics
- Radiology
Background:
- Cat scratch disease (CSD) is typically caused by Bartonella henselae, often presenting with lymphadenopathy and sometimes hepatosplenic lesions.
- Atypical CSD manifestations, such as prolonged fever and multiple organ involvement, can pose diagnostic challenges.
- Multiple renal lesions are an exceptionally rare finding in CSD cases.
Observation:
- An 11-year-old Japanese girl experienced prolonged fever after a kitten scratch and bite.
- Abdominal computed tomography (CT) revealed multiple small, hypodense lesions in both kidneys and the spleen.
- Serological tests confirmed the presence of antibodies against Bartonella henselae.
Findings:
- The patient was diagnosed with CSD based on clinical presentation, imaging findings, and serological confirmation.
- Treatment with azithromycin led to immediate improvement of the prolonged fever.
- This case represents the first reported instance in Japan of CSD with concurrent multiple renal and splenic lesions.
Implications:
- Accurate diagnosis of atypical CSD requires careful patient history and comprehensive imaging interpretation, including renal lesions.
- Early identification and treatment of CSD can prevent potential complications and the need for invasive procedures.
- Recognizing renal involvement in CSD imaging is crucial for timely diagnosis and management, particularly in pediatric cases.
