Madison Area Lyme Support Group

Diagnosis of systemic cat scratch disease may be challenging. Here, we describe a case of an immunocompetent girl exhibiting fever and multifocal hepatosplenic abscesses. Diagnostic tests for Bartonella henselae infection (enzyme immunoassay and polymerase chain reaction) were found steadily negative and the diagnosis, suspected on the basis of the Margilet’s criteria, was finally confirmed by indirect immunofluorescent antibodies.

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**Comment**

“Troublesome” is certainly an understatement!

According to this, hepatosplenic abscesses in CSD are rarely reported in immunocompetent children, and only 36 cases are listed in various databases:  https://pubmed.ncbi.nlm.nih.gov/31307480/