Cat-scratch disease simulating a malignant process of the chest wall

Cat-scratch disease is a well-known cause of regional adenopathy in immunoc ompetent children. Rarely, patients may present with symptoms simulating a neoplastic disease. The case of a 12-year-old boy with fever, swelling of t he chest wall and hepatosplenic nodules is reported. Histological analysis of biopsy specimen obtained from the chest wall lesion and the liver reveal ed granulomatous reaction without malignant cells. Serological investigatio ns were positive for Bartonella species. The symptoms and the lesions disap peared after oral antibiotic therapy (ciprofloxacin) was started. The patie nt remained symptom-free 12 months later. Conclusion The present case emphasizes the wide spectrum of clinical manife stations associated with cat-scratch disease which should be investigated a s differential diagnosis of manifestations suggesting a neoplastic disease in children.