Cat Scratch Disease (CSD)
 A |
 B |
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| Findings of CSD show the typical inflammatory epitrochlear nodule. The nodule is isointense to muscle on T1 (A,B,C). | ||
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| Hyperintense to muscle on T2 (D), and shows heterogeneous enhancement after gadolinium administration on T1 FS post image(E). Note the central fatty center of lymph node with increased vascularity. | ||
Cat Scratch Disease (CSD) is a cause for regional lymphadenitis. It often presents 3-10 days after exposure with a painful poorly defined soft tissue mass which can be confused for lymphoma, sarcoma, breast carcinoma, or hematoma and thus clinical history is important1,3. The lymphadenopathy is usually located in the axilla, inguinal region, head and neck, and epitrochlear regions3. Diagnosis includes lymphadenopathy 10mm or larger for greater than 3 weeks plus 3 of the following 4 criteria; Contact with a cat with our without a scratch, radiology findings suspicious for CSD, Enzyme linked immunosorbent assay (ELISA), or biopsy showing granulomatous inflammation compatible with CSD2. The lymphadenopathy is caused by bartonella henselae which is a soil borne pathogens common to felines4. May have persistent fever, abdominal pain, severe systemic symptoms, and regional soft tissue mass. The disorder left untreated is self limiting usually resolving by several months even without antibiotic therapy. Imaging findings on CT and MRI reveal an ill defined soft tissue mass with extensive surrounding edema. The mass is isointense to muscle on T1 and hyperintense on T2 showing heterogeneous enhancement after gadolinium administration1. On abdominal CT will see multiple hypodense lesions of liver and spleen which will ultimately calcify after weeks to months2.
1. Dong PR, Seeger LL, Yao L et al. Uncomplicated Cat-Scratch Disease: Findings at CT, MR Imaging, and Radiography. Radiology 1995:837-839.
2. Nervi SJ, Kapila R et al. Cat scratch Disease: Differential Diagnoses and Workup. emedicine. Jan 26, 2009.
3. Jacob J, Gaikwad A, Ghadge P. Cat scratch disease presenting as right lower arm swelling. Indian Journal of Radiology and Imaging 2006:16:341-343.
4. Beaman FD et al. Superficial Soft-Tissue Masses: Analysis, Diagnosis, and Differential Considerations. Radiographics 2004:27:2;509-523.
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Tags: Cat Scratch Disease, CSD, hyperintense, lymphadenitis, lymphadenopathy