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Variety of diagnostic challenges in atypical cat scratch disease

Published:November 15, 2022DOI:https://doi.org/10.1016/j.jiac.2022.11.003
      Recently, Kagatani et al. published a case report showing the usefulness of whole body diffusion-weighted imaging (WB-DWI), a type of magnetic resonance imaging (MRI), in the diagnosis of fever of unknown origin (FUO) [
      • Kagatani J.
      • Asakura T.
      • Sekine K.
      • Watanabe H.
      • Kawada M.
      • Ohkusu K.
      • et al.
      Clinical utility of whole body diffusion-weighted imaging in an immunocompetent adult with atypical cat scratch disease.
      ]. The patient was a 23-year-old immunocompetent adult man who owned cats but had no history of cat scratches. WB-DWI detected multiple abscesses in the liver, spine, and pelvis, which provided a clue to diagnosing atypical cat scratch disease (CSD). Furthermore, a biopsy of an abscess lesion in the liver was performed, and Bartonella henselae DNA was detected from the liver abscess aspirate by polymerase chain reaction (PCR) test, leading to a definitive diagnosis. Because atypical CSD presents various symptoms and signs and is often difficult to diagnose, it is crucial to optimize the process leading to its diagnosis.

      Keywords

      Abbreviations:

      CT (computed tomography), CSD (cat scratch disease), FUO (fever of unknown origin), MRI (magnetic resonance imaging), PCR (polymerase chain reaction), WB-DWI (whole body diffusion-weighted imaging)
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