Cat-scratch disease

Case contributed by Dr Balint Botz

Presentation

Palpable, rapidly appearing painful mass in the region of the left elbow. Subfebrile upon presentation. Cat owner.

Patient Data

Age: 60 years
Gender: Male
X-ray

Soft-tissue swelling with circumscribed nodular lesions (see rewindowed image) in the area corresponding to the location of the epitrochlear lymph nodes. 

No bony abnormality. 

Ultrasound

An enlarged superficial lymph node with thickened cortex is visible corresponding to the palpable mass. The lymph node shows marked hypervascularity. A similar but smaller additional lymph node is visible in its proximity. Altogether findings are suggestive of reactive lymph node enlargement most likely due to infection. 

MRI

Both lymph nodes show vivid enhancement, and adjacent soft tissue stranding.

No bony abnormality. 

Case Discussion

The patient tested positive for Bartonella henselae, the causative bacterium of cat-scratch disease (bartonellosis). Antibiotic therapy resulted in rapid recovery. 

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Case information

rID: 77817
Published: 22nd May 2020
Last edited: 23rd May 2020
Inclusion in quiz mode: Included
Institution: University of Pécs

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