2017 Volume 45 Issue 1 Pages 49-54
Case Report: A 13-year-old girl had noticed a lump and tenderness in her left inner thigh 2 weeks prior to hospital admission. As symptoms became aggravated over time and the lump gradually increased in size, she presented for examination at a local orthopedic surgery clinic, where plain computed tomography (CT) revealed a soft-tissue mass in the left inner thigh. She was therefore referred to our hospital for further investigation and treatment. Tests were negative for Bartonella henselae immunoglobulin (Ig) M, but the B. henselae IgG titer was 1: 1024, and polymerase chain reaction (PCR) for cat-scratch disease from an excised lymph node specimen was positive, and cat-scratch disease was diagnosed on the basis of these results. Although the patient had a history of keeping cats, no cat bites or other injury was evident. Closer questioning after admission revealed that the patient had been bitten several times by fleas from the cats. In the event of suspected cat-scratch disease, it is important to ask patients not only about bites from pets, but also about a detailed history of contact with possible parasites of the pets such as fleas.
