TY - JOUR
T1 - Cat scratch disease, a rare cause of hypodense liver lesions, lymphadenopathy and a protruding duodenal lesion, caused by Bartonella henselae
AU - van Ierland-van Leeuwen, Marloes
AU - Peringa, Jan
AU - Blaauwgeers, Hans
AU - van Dam, Alje
PY - 2014
Y1 - 2014
N2 - A 46-year-old woman presented with right upper abdominal pain and fever. At imaging, enlarged peripancreatic and hilar lymph nodes, as well as hypodense liver lesions, were detected, suggestive of malignant disease. At endoscopy, the mass adjacent to the duodenum was seen as a protruding lesion through the duodenal wall. A biopsy of this lesion, taken through the duodenal wall, showed a histiocytic granulomatous inflammation with necrosis. Serology for Bartonella henselae IgM was highly elevated a few weeks after presentation, consistent with the diagnosis of cat scratch disease. Clinical symptoms subsided spontaneously and, after treatment with azithromycin, the lymphatic masses, liver lesions and duodenal ulceration disappeared completely.
AB - A 46-year-old woman presented with right upper abdominal pain and fever. At imaging, enlarged peripancreatic and hilar lymph nodes, as well as hypodense liver lesions, were detected, suggestive of malignant disease. At endoscopy, the mass adjacent to the duodenum was seen as a protruding lesion through the duodenal wall. A biopsy of this lesion, taken through the duodenal wall, showed a histiocytic granulomatous inflammation with necrosis. Serology for Bartonella henselae IgM was highly elevated a few weeks after presentation, consistent with the diagnosis of cat scratch disease. Clinical symptoms subsided spontaneously and, after treatment with azithromycin, the lymphatic masses, liver lesions and duodenal ulceration disappeared completely.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84931863575&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/25355744
U2 - https://doi.org/10.1136/bcr-2014-203626
DO - https://doi.org/10.1136/bcr-2014-203626
M3 - Article
C2 - 25355744
SN - 1757-790X
VL - 2014
JO - BMJ Case Reports
JF - BMJ Case Reports
ER -