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July 1995

Pathological Case of the Month

Author Affiliations

From the Departments of Pathology and Laboratory Medicine (Drs Ackerman and Gilbert-Barness) and Pediatrics (Dr Emmanuel), University of South Florida, Tampa.

Arch Pediatr Adolesc Med. 1995;149(7):821-822. doi:10.1001/archpedi.1995.02170200111020

A 6-YEAR-OLD boy complained of evening fevers, with a temperature of 38.9°C to 39.4°C and diffuse abdominal pain for 9 days. He denied any chills, vomiting, or change in bowel habits or appetite. The patient lived with his mother and two brothers in a trailer home with well water. He denied any exposure to pets. Physical examination revealed a diffusely tender abdomen with bilateral inguinal and cervical adenopathy. Ultrasonography and a computed tomographic scan of the abdomen confirmed both liver and spleen abscesses. A splenectomy and liver biopsy were performed, and histologic sections of the liver (Figure 1 and Figure 2) and spleen (Figure 3 and Figure 4) are shown below.

Diagnosis and Discussion 

Systemic Cat-scratch Disease  After an extensive workup for bacterial, viral, and fungual sources, a diagnosis of systemic catscratch disease