HEPATIC AND SPLENIC LOCALIZATIONS DUE TO CAT-SCRATCH DISEASE - A REPORT OF 3 CASES

In three patients with cat-scratch disease (CSD) the liver and the spl een were affected. All three had prolonged fever and abdominal pain. A n abdominal ultrasound revealed numerous hypoechoic nodules and comput erized tomography also demonstrated hypodenses lesions throughout the Liver and the spleen. At laparotomy, there were nodules on the liver a nd the spleen surfaces and histological examination revealed necrotizi ng pyoepithelioic granulomas. The nodules resolved in six months with replacement by multiple calcifications. Hepatosplenic CSD should now b e considered in the differential diagnosis of fever of unknown origin and granulomatous hepatitis. The knowledge of atypical manifestations of CSD and improvement of serology would avoid in these circumstances the need of a biopsy specimen.