Case Report

Disseminated Cat Scratch Disease With Vertebral Osteomyelitis and Epidural Abscess

Authors: Nahed Abdel-Haq, MD, Walid Abuhammour, MD, Hossam Al-Tatari, MD, Basim Asmar, MD


A 5-year-old boy with cat scratch disease presented with fever of unknown origin and osteomyelitis of the thoracic spine and epidural abscess. He did not have localizing signs or symptoms. Computed tomography of the abdomen, which was initially negative, showed hepatosplenic disease. Cat scratch disease has variable systemic presentations and should be included in the differential diagnosis of fever of unknown origin if an epidemiologic risk factor is present.

Key Points

* Cat scratch disease may be a systemic disease rather than localized lymphadenitis.

* In addition to hepatosplenic involvement, disseminated cat scratch disease may include focal bone and nervous system disease.

* Cat scratch disease should be suspected in children with fever of unknown origin and epidemiologic risk factors such as cat exposure.

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