Axillary cat-scratch disease: A case report and literature review

RATIONALE: Cat-scratch disease (CSD) typically presents as self-limited regional lymphadenopathy following a cat scratch or exposure. Its clinical features can mimic malignancy or tuberculosis, especially in elderly patients, leading to potential misdiagnosis. This report underscores the importance of considering CSD in elderly individuals with unexplained fever and atypical lymphadenopathy. PATIENT CONCERNS: A 67-year-old woman presented with a 3-month history of left axillary swelling, accompanied by pain and fever for 3 days. DIAGNOSES: Axillary CSD was confirmed based on clinical presentation, exposure history, and lymph node biopsy findings. INTERVENTIONS: The patient received compound sulfamethoxazole tablets as anti-infective therapy. OUTCOMES: Two weeks post-treatment, the patient was afebrile, and the surgical incision had healed. LESSONS: This case highlights the diagnostic challenges of CSD in the elderly. Early lymph node biopsy and careful elicitation of exposure history are essential to avoid misdiagnosis, particularly with malignancy. Timely intervention can prevent unnecessary procedures and improve prognosis. Evaluation of confirmed cases should also include an assessment for potential extra-nodal spread to sites such as the liver, colon, and retina.