Abstract
A 13-year-old female came to our clinic with a wound in the right infraorbital area and swelling in the right submandibular area that had been present for 1 week. An intraoral examination revealed a normal salivary flow, while the swelling had an inflammatory appearance and was tender under palpation, which suggested the presence of purulence. As it seemed to be originating from a lymph node, a provisional diagnosis of acute purulent lymphadenitis was made.
Surgical drainage and antibiotic therapy (Flomoxef Sodium, Flumarin®, Shionogi, Japan) was performed, however,2 days later the lymph node remained swollen. At this occasion, the patient reported that some days earlier, her brother had visited another hospital due to a swelling on his left arm. Thus, cat scratch disease (CSD), a very common type of zoonosis, was suspected.
After further confirmation of the circumstances, the antibiotic therapy was changed to minocycline (Minomycin®, Wyeth Lederie Japan, Japan) and a PCR assay of the pus obtained from the swelling showed the presence of Bartonella henselae, the etiologic agent of CSD.
In the present case, implementation of a PCR examination allowed a prompt diagnosis of CSD, and eliminated the need for more extensive diagnostic and therapeutic procedures.
