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Open Access Highly Accessed Letter to the Editor

A case report of seronegative cat scratch disease, emphasizing the histopathologic point of view

Ok Ran Shin1, Yang Ree Kim2, Tae-hyun Ban2, Taeseok Lim2, Tae Hee Han3, Su Yeon Kim4 and Kyung Jin Seo1*

Author Affiliations

1 Department of Hospital Pathology, Uijeongbu St. Mary’s Hospital College of Medicine, The Catholic University of Korea 271, Cheonbo-ro, Uijeongbu-si, Gyenggi-do 480-717, Republic of Korea

2 Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea

3 Department of Laboratory Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea

4 Division of Zoonoses (CJD/Rabies/LB), Center for Immunology & Pathology, National Institute of Health (Korea CDC), Seoul, Korea

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Diagnostic Pathology 2014, 9:62  doi:10.1186/1746-1596-9-62

Published: 19 March 2014

Abstract

Cat scratch disease, necrotizing granulomatous lymphadenitis caused by Bartonella henselae, usually benign and self-limited. However, various clinical manifestations and no pathognomonic histopathologic features can lead to misinterpretations and diagnostic disputes. We report a case of cat scratch disease in a 39-yr-old male patient with fever and left axillary lymphadenitis. He had a history of cat bite on the left hand dorsum. On excision, the lymph node showed follicular hyperplasia, stellate microabscesses with a rim of granulomatous inflammation. Warthin-Starry silver staining showed many clumps of silver-stained bacilli within the necrotic foci. Serological tests were negative. Diagnosis was established by PCR analysis.

The virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1877499238123059 webcite

Keywords:
Cat scratch disease; Bartonella; Warthin-Starry silver stain; PCR; Histological features; Differential diagnosis