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Hepatosplenic Abscesses and Osteomyelitis of the Spine in an Immunocompetent Adult with Cat Scratch Disease.

Knafl D, Lötsch F, Burgmann H, Goliasch G, Poeppl W, Ramharter M, Thalhammer F, Schuster C - Case Rep Infect Dis (2015)

Bottom Line: Abdominal computed tomography showed multiple hypodense hepatosplenic lesions and osteomyelitis of the thoracic and lumbar spine with base plate fracture.Due to its variety of clinical presentations, diagnosis of CSD is challenging, especially in the absence of a history of specific exposure.Nevertheless CSD has many different and rare forms of presentations, including hepatosplenic lesions and bone involvement as shown in this case.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria.

ABSTRACT
We present an 18-year-old, immunocompetent Austrian military conscript with cervical lymphadenopathy, fever, back-pain, and persistent inflammation markers despite two weeks of antimicrobial therapy with ampicillin/sulbactam. All specific laboratory investigations for identification of a specific etiology, including blood cultures and autoantibodies, were inconspicuous. Abdominal computed tomography showed multiple hypodense hepatosplenic lesions and osteomyelitis of the thoracic and lumbar spine with base plate fracture. Based on the patient's history, clinical presentation, and radiological findings, serology for cat scratch disease (CSD) was performed and high B. henselae specific IgM and IgG antibodies were detected. Due to its variety of clinical presentations, diagnosis of CSD is challenging, especially in the absence of a history of specific exposure. This case report shall remind the physician that cat scratch disease is a common disease, mainly presenting with fever and lymphadenopathy in young patients. Nevertheless CSD has many different and rare forms of presentations, including hepatosplenic lesions and bone involvement as shown in this case.

No MeSH data available.


Related in: MedlinePlus

Computer tomography (CT) of the chest and abdomen. Transverse views showed multiple hepatic and splenic lesions.
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Related In: Results  -  Collection


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fig1: Computer tomography (CT) of the chest and abdomen. Transverse views showed multiple hepatic and splenic lesions.

Mentions: Due to the patient's symptoms, such as fever and lymphadenopathy, and his inconclusive laboratory findings, a CT scan was performed, which showed multiple hypodense hepatic and splenic lesions; the largest is 2 cm in diameter (Figure 1). Furthermore subchondral sclerosis and erosion of the ventral thoracic spine were shown with maximal affection of the seventh vertebral body.


Hepatosplenic Abscesses and Osteomyelitis of the Spine in an Immunocompetent Adult with Cat Scratch Disease.

Knafl D, Lötsch F, Burgmann H, Goliasch G, Poeppl W, Ramharter M, Thalhammer F, Schuster C - Case Rep Infect Dis (2015)

Computer tomography (CT) of the chest and abdomen. Transverse views showed multiple hepatic and splenic lesions.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4631868&req=5

fig1: Computer tomography (CT) of the chest and abdomen. Transverse views showed multiple hepatic and splenic lesions.
Mentions: Due to the patient's symptoms, such as fever and lymphadenopathy, and his inconclusive laboratory findings, a CT scan was performed, which showed multiple hypodense hepatic and splenic lesions; the largest is 2 cm in diameter (Figure 1). Furthermore subchondral sclerosis and erosion of the ventral thoracic spine were shown with maximal affection of the seventh vertebral body.

Bottom Line: Abdominal computed tomography showed multiple hypodense hepatosplenic lesions and osteomyelitis of the thoracic and lumbar spine with base plate fracture.Due to its variety of clinical presentations, diagnosis of CSD is challenging, especially in the absence of a history of specific exposure.Nevertheless CSD has many different and rare forms of presentations, including hepatosplenic lesions and bone involvement as shown in this case.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria.

ABSTRACT
We present an 18-year-old, immunocompetent Austrian military conscript with cervical lymphadenopathy, fever, back-pain, and persistent inflammation markers despite two weeks of antimicrobial therapy with ampicillin/sulbactam. All specific laboratory investigations for identification of a specific etiology, including blood cultures and autoantibodies, were inconspicuous. Abdominal computed tomography showed multiple hypodense hepatosplenic lesions and osteomyelitis of the thoracic and lumbar spine with base plate fracture. Based on the patient's history, clinical presentation, and radiological findings, serology for cat scratch disease (CSD) was performed and high B. henselae specific IgM and IgG antibodies were detected. Due to its variety of clinical presentations, diagnosis of CSD is challenging, especially in the absence of a history of specific exposure. This case report shall remind the physician that cat scratch disease is a common disease, mainly presenting with fever and lymphadenopathy in young patients. Nevertheless CSD has many different and rare forms of presentations, including hepatosplenic lesions and bone involvement as shown in this case.

No MeSH data available.


Related in: MedlinePlus