RT Journal Article
SR Electronic
T1 Cat-scratch disease mimicking lymp node tuberculosis about four cases
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P561
VO 40
IS Suppl 56
A1 Jean-Baptiste Obstler
A1 Elodie Verger
A1 Elodie Barras
A1 Caroline Clarot
A1 Oliver Leleu
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P561.abstract
AB Cat-scratch disease (CSD) is a bacterial infection due to Bartonella henselae. It's usually present as isolated lymphadenopathy.Lymphadenopathy histological examination is often non specific. It can be revealed an epithelioid necrotizing granuloma just like lymph node tuberculosis.We report four cases refered in our institution for tubercular lymphadenitis suspicion, which were in fact CSD.Patients were aged between 15 and 61 years old, healthy, without biologic inflammation. Regional lymphadenopathy without any other lesions was confirmed by CT scans. Biopsy were realized for all patients. Histological analysis was necrotizing epithelioid granuloma and giant cells. Ziehl-Neelsen method and quantiFERON-TB GOLD test were negative whereas serologic tests for Bartonella henselae were positive. One patient does not remember contact with cat. Two patients were treated by antibiotic. Outcome of all cases was favorable.Cat-scratch disease stays a difficult diagnostic. Clinicians must keep this diagnosis possibility in mind when lymph node analysis presents an necrotizing epithelioid granuloma with giant cells. A systematic clinical and laboratory testing approach is necessary. Serology is the best initial test and can be performed by immunofluorescence assay. Moreover polymerase chain reaction can be useful. Indication of antibiotic treatment is reserved to complicated CSD.