Cat scratch disease mimicking malignancy in abdominal lymphadenopathy: an interdisciplinary approach to non-invasive diagnosis and treatment

Cat scratch disease (CSD) is an infectious disease transmitted by animals. The diagnostic approach for CSD may include both imaging studies and serological tests. In complex cases, biopsies are frequently performed for histopathological examination. The rising prevalence of cat ownership in Polish households (now exceeding 40%) linked with the nonspecific symptoms of CSD contributes to its emergence as a public health problem. An 11-year-old girl was hospitalized with a fever reaching 40°C and respiratory dysfunction. A chest X-ray did not reveal any abnormalities. An abdominal ultrasound scan revealed numerous enlarged lymph nodes near the hepatic hilum. Contrast-enhanced computed tomography (CT) revealed focal changes in the liver and a lesion modeling the head of the pancreas and a section of the common bile duct. Given the nonspecific nature of her symptoms, histopathological examination of the lesions was initially recommended. However, following positive IgM and IgG antibody results for Bartonella henselae, a definitive diagnosis was established. CSD represents a diagnostic challenge because of the diverse symptoms and the wide age range of affected individuals. Therefore, a multidisciplinary approach in CSD can be crucial to emerging new diagnostic ideas. Early serological testing can expedite the initiation of a successful CSD treatment. Avoiding invasive procedures for pediatric patients should be also considered. Standardized protocols and timely health check-ups play a crucial role in preventing zoonotic transmission.