Cat Scratch Disease: A Diagnostic Challenge in Cervical Lymphadenopathy
Introduction: Cat scratch disease typically manifests as long standing regional lymphadenopathy, though clinical features may cover a wide spectrum. Lack of definite history of cat scratch, atypical presentation, non-availability of serological tests and misleading needle cytology may often lead to...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Association of Otolaryngologists of India, West Bengal
2024-05-01
|
| Series: | Bengal Journal of Otolaryngology and Head Neck Surgery |
| Subjects: | |
| Online Access: | https://bjohns.in/journal23/index.php/bjohns/article/view/84 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823858944011927552 |
|---|---|
| author | Bipin Kishore Prasad Yamuna Ranganathan Gunjan Dwivedi Devika Gupta |
| author_facet | Bipin Kishore Prasad Yamuna Ranganathan Gunjan Dwivedi Devika Gupta |
| author_sort | Bipin Kishore Prasad |
| collection | DOAJ |
| description |
Introduction: Cat scratch disease typically manifests as long standing regional lymphadenopathy, though clinical features may cover a wide spectrum. Lack of definite history of cat scratch, atypical presentation, non-availability of serological tests and misleading needle cytology may often lead to delay in diagnosis.
Case report: A 44 years old diabetic female, presented with persistent fever for 15 days followed by 4x4cm, tender tense swelling in left parotid region extending into upper neck. Her blood sugar was deranged. Polymorphonuclear leucocytosis was noted. Radiological investigation showed lymph nodal conglomeration involving level II, III and IV with non-enhancing necrotic areas within it. Mass was abutting Internal Jugular Vein, which was attenuated cranially. Aggressive antibiotics treatment and optimal glycemic control failed to resolve fever and lymphadenopathy, hence excision of neck mass was done which was reported histopathologically as Cat Scratch Disease.
Conclusion: While ruling out tuberculosis, Epstein Barr-Virus infection, acute bacterial lymphadenitis or malignant disease, Cat Scratch Disease should be included in the differential diagnosis of lymphadenopathies in head-neck region so that possibility of antibiotic abuse, an unnecessary biopsy, long term antitubercular drug therapy or even surgical treatment may be avoided.
Keywords: Cat Scratch Disease; Bartonella henselae; lymphadenopathy; serological test
|
| format | Article |
| id | doaj-art-d82e8a23bdbd424aae9f7ff972b98ee3 |
| institution | Kabale University |
| issn | 2395-2393 2395-2407 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | The Association of Otolaryngologists of India, West Bengal |
| record_format | Article |
| series | Bengal Journal of Otolaryngology and Head Neck Surgery |
| spelling | doaj-art-d82e8a23bdbd424aae9f7ff972b98ee32025-02-11T09:43:33ZengThe Association of Otolaryngologists of India, West BengalBengal Journal of Otolaryngology and Head Neck Surgery2395-23932395-24072024-05-0131310.47210/bjohns.2023.v31i3.84Cat Scratch Disease: A Diagnostic Challenge in Cervical LymphadenopathyBipin Kishore Prasad0Yamuna Ranganathan1Gunjan Dwivedi2Devika Gupta3Command Hospital (Central Command), LucknowCommand hospital (Eastern Command), Kolkata-700027Command Hospital (Eastern Command), KolkataCommand hospital (Eastern Command), Kolkata Introduction: Cat scratch disease typically manifests as long standing regional lymphadenopathy, though clinical features may cover a wide spectrum. Lack of definite history of cat scratch, atypical presentation, non-availability of serological tests and misleading needle cytology may often lead to delay in diagnosis. Case report: A 44 years old diabetic female, presented with persistent fever for 15 days followed by 4x4cm, tender tense swelling in left parotid region extending into upper neck. Her blood sugar was deranged. Polymorphonuclear leucocytosis was noted. Radiological investigation showed lymph nodal conglomeration involving level II, III and IV with non-enhancing necrotic areas within it. Mass was abutting Internal Jugular Vein, which was attenuated cranially. Aggressive antibiotics treatment and optimal glycemic control failed to resolve fever and lymphadenopathy, hence excision of neck mass was done which was reported histopathologically as Cat Scratch Disease. Conclusion: While ruling out tuberculosis, Epstein Barr-Virus infection, acute bacterial lymphadenitis or malignant disease, Cat Scratch Disease should be included in the differential diagnosis of lymphadenopathies in head-neck region so that possibility of antibiotic abuse, an unnecessary biopsy, long term antitubercular drug therapy or even surgical treatment may be avoided. Keywords: Cat Scratch Disease; Bartonella henselae; lymphadenopathy; serological test https://bjohns.in/journal23/index.php/bjohns/article/view/84Cat Scratch DiseaseBartonella henselaelymphadenopathyserological test |
| spellingShingle | Bipin Kishore Prasad Yamuna Ranganathan Gunjan Dwivedi Devika Gupta Cat Scratch Disease: A Diagnostic Challenge in Cervical Lymphadenopathy Bengal Journal of Otolaryngology and Head Neck Surgery Cat Scratch Disease Bartonella henselae lymphadenopathy serological test |
| title | Cat Scratch Disease: A Diagnostic Challenge in Cervical Lymphadenopathy |
| title_full | Cat Scratch Disease: A Diagnostic Challenge in Cervical Lymphadenopathy |
| title_fullStr | Cat Scratch Disease: A Diagnostic Challenge in Cervical Lymphadenopathy |
| title_full_unstemmed | Cat Scratch Disease: A Diagnostic Challenge in Cervical Lymphadenopathy |
| title_short | Cat Scratch Disease: A Diagnostic Challenge in Cervical Lymphadenopathy |
| title_sort | cat scratch disease a diagnostic challenge in cervical lymphadenopathy |
| topic | Cat Scratch Disease Bartonella henselae lymphadenopathy serological test |
| url | https://bjohns.in/journal23/index.php/bjohns/article/view/84 |
| work_keys_str_mv | AT bipinkishoreprasad catscratchdiseaseadiagnosticchallengeincervicallymphadenopathy AT yamunaranganathan catscratchdiseaseadiagnosticchallengeincervicallymphadenopathy AT gunjandwivedi catscratchdiseaseadiagnosticchallengeincervicallymphadenopathy AT devikagupta catscratchdiseaseadiagnosticchallengeincervicallymphadenopathy |