TY - JOUR
T1 - GRANULOMATOUS HEPATITIS ASSOCIATED WITH CAT SCRATCH DISEASE
AU - Lenoir, Allen A.
AU - Storch, Gregory A.
AU - Deschryver-Kecskemeti, Katherine
AU - Shackelford, Gary D.
AU - Wear, Douglas J.
AU - Rothbaum, Robert J.
AU - Rosenblum, Jerry L.
PY - 1988/5/21
Y1 - 1988/5/21
N2 - In three patients with cat scratch disease the liver was affected. All three had high fever (39°C) for more than 3 weeks. Two of them had no peripheral adenopathy. Computed tomography of the abdomen revealed focal hepatic defects in two patients and periportal and periaortic adenopathy in the third. At laparotomy, there were nodules on the liver surfaces of all patients and histological examination revealed necrotising granulomata. The Warthin-Starry silver stain showed organisms consistent in appearance with the cat scratch bacillus in the liver and a periaortic lymph node of one patient, in the liver of the second patient, and in the axillary lymph node of the third. In all three patients the clinical findings and radiological abnormalities improved without specific therapy. A review of the surgical pathology files of Washington University revealed only two other cases of granulomatous hepatitis in children over a 6-year period. These findings indicate that cat scratch disease should now be included in the differential diagnosis of granulomatous hepatitis, at least in children. The absence of peripheral adenopathy in two of the three patients with granulomatous hepatitis suggests that the clinical spectrum of cat scratch disease may be broader than previously appreciated.
AB - In three patients with cat scratch disease the liver was affected. All three had high fever (39°C) for more than 3 weeks. Two of them had no peripheral adenopathy. Computed tomography of the abdomen revealed focal hepatic defects in two patients and periportal and periaortic adenopathy in the third. At laparotomy, there were nodules on the liver surfaces of all patients and histological examination revealed necrotising granulomata. The Warthin-Starry silver stain showed organisms consistent in appearance with the cat scratch bacillus in the liver and a periaortic lymph node of one patient, in the liver of the second patient, and in the axillary lymph node of the third. In all three patients the clinical findings and radiological abnormalities improved without specific therapy. A review of the surgical pathology files of Washington University revealed only two other cases of granulomatous hepatitis in children over a 6-year period. These findings indicate that cat scratch disease should now be included in the differential diagnosis of granulomatous hepatitis, at least in children. The absence of peripheral adenopathy in two of the three patients with granulomatous hepatitis suggests that the clinical spectrum of cat scratch disease may be broader than previously appreciated.
UR - http://www.scopus.com/inward/record.url?scp=0023890498&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(88)91952-6
DO - 10.1016/S0140-6736(88)91952-6
M3 - Article
C2 - 2896959
AN - SCOPUS:0023890498
SN - 0140-6736
VL - 331
SP - 1132
EP - 1136
JO - The Lancet
JF - The Lancet
IS - 8595
ER -