CHEST-WALL ABSCESS DUE TO CAT-SCRATCH DISEASE (CSD) IN AN ADULT WITH ANTIBODIES TO BARTONELLA-CLARRIDGEIAE - CASE-REPORT AND REVIEW OF THE THORACOPULMONARY MANIFESTATIONS OF CSD

We describe a patient who presented with a massive chest-wall abscess after a severe debilitating illness that lasted 3 months. Steroid ther apy, administered for 4 weeks, masked the slow development of an exten sive axillary and chest-wall abscess. After multiple negative tests, t he patient's prolonged illness was diagnosed as cat-scratch disease (C SD). An indirect fluorescent antibody test revealed that two convalesc ent serum samples were positive for IgG to Bartonella clarridgeiae, bu t no other Bartonella species. We also review 12 cases of severe chest and pulmonary disease due to CSD that were reported in the English-la nguage literature. Thoracopulmonary findings associated with CSD, path ogenic mechanisms of bartonella infections, diagnostic criteria, and m anagement of CSD are presented.