Multiple Renal and Splenic Lesions in Cat Scratch Disease

作者：Wakiguchi Hiroyuki^*; Okamoto Yasuhiro; Matsunaga Manaka; Kodama Yuichi; Miyazono Akinori; Seki Shunji; Ikeda Naohiro; Kawano Yoshifumi

来源：Japanese Journal of Infectious Diseases, 2016, 69(5): 424-425.

DOI：10.7883/yoken.JJID.2015.362

Cat scratch disease (CSD) is an infectious disease caused by Bartonella henselae. Atypical clinical presentations of CSD include prolonged fever and multiple hepatosplenic lesions. Furthermore, multiple renal lesions are extremely rare in CSD. An 11-year-old Japanese girl presented at our hospital with a prolonged fever of unknown cause after being scratched and bitten by a kitten. Abdominal computed tomography (CT) revealed multiple small, round hypodense lesions in both kidneys and the spleen. Based on her history and the CT results, her diagnosis was CSD. The diagnosis was confirmed by serological tests, which indicated antibodies against B. henselae. After treatment with azithromycin, her fever immediately improved. Careful history taking and imaging are essential for the diagnosis of atypical CSD. In CT images, not only hepatosplenic lesions but also renal lesions are important features indicative of a diagnosis of atypical CSD. Subsequently, a diagnosis of CSD can be confirmed by specific serological tests. This is the first reported Japanese case of multiple renal and splenic lesions in a patient with CSD. Although difficult to diagnose, an early diagnosis atypical CSD and appropriate treatment are important to prevent complications and the need for invasive examinations.

• 出版日期2016-9