Cat-scratch disease presenting as a solitary splenic abscess in an immunocompetent adult: case report and literature review

Abstract

Cat-scratch disease is a common zoonotic infectious disease caused by Bartonella henselae. It is generally characterized by regional lymphadenopathy following exposure to an infected cat. Organ systemic manifestations occur rarely in atypical forms of the disease. Abscess of the spleen represents a rare, life-threatening clinical entity. Here we report an unusual case of cat scratch disease presenting as an isolated splenic abscess in an immunocompetent adult. Comprehensive social history revealed retrospectively close contact with cats. Diagnosis of B. henselae infection was confirmed on the basis of positive serology, skin lesion and imaging findings. Initial efforts at spleen preserving management failed to improve clinical symptoms and classical splenectomy was finally performed. Splenic bartonellosis may become potentially fatal if not recognized. Since diagnosis is challenging, a high index of clinical suspicion is required.