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Granulomatous hepatitis associated with cat scratch disease.
A A Lenoir1, G A Storch, K DeSchryver-Kecskemeti
1Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine.
Lancet (London, England)
|May 21, 1988
Summary
Cat scratch disease can affect the liver, causing granulomatous hepatitis, even without swollen lymph nodes. This condition in children often improves on its own, broadening the disease
Area of Science:
- Hepatology
- Infectious Diseases
- Pediatrics
Background:
- Cat scratch disease (CSD) is a bacterial infection typically associated with lymphadenopathy.
- Hepatic involvement in CSD is uncommon but can present as granulomatous hepatitis.
Observation:
- Three pediatric patients presented with prolonged fever and hepatic abnormalities.
- Two patients lacked peripheral adenopathy, a common sign of CSD.
- Imaging revealed focal hepatic defects and/or adenopathy.
Findings:
- Liver biopsies showed necrotizing granulomata.
- Warthin-Starry stain identified *Bartonella henselae* in liver and lymph node tissues.
- Clinical and radiological findings resolved spontaneously in all patients.
Implications:
- CSD should be considered in the differential diagnosis of pediatric granulomatous hepatitis.
- The absence of peripheral adenopathy does not exclude CSD.
- This broadens the recognized clinical spectrum of cat scratch disease.