Diagnostic considerations for cat-scratch disease illustrated by clinical examples

Cat-scratch disease (CSD) is one of the most common causes of chronic lymphadenopathy in children. The ratio of typical to atypical systemic forms of felinosis is 6 : 1. Human infection typically occurs as a result of a bite or scratch from cats, and less often from dogs and rodents. The main causative agent of CSD is Bartonella henselae. Aim. To demonstrate the features of the disease course and the diagnostic challenges of cat-scratch disease by presenting two clinical cases in children. Materials and methods. Two clinical examples of typical and atypical forms of cat scratch disease in children are presented. The presence of IgM to Bartonella henselae, confirmed the diagnosis of cat scratch disease. Results. Typical and atypical clinical signs and stages of CSD differential diagnosis between diseases accompanied by similar symptoms, namely bacterial lymphadenitis, sepsis, lymphonodular form of toxoplasmosis, systemic inflammatory disease, have been demonstrated. Conclusions. CSD should be considered a potential cause of isolated lymphadenitis in children. When a patient presents with a fever of unknown origin, unilateral lymphadenopathy, and inflammatory changes in complete blood count, the differential diagnosis should include not only oncohematological diseases, lymph node tuberculosis, systemic inflammatory diseases, but also CSD.