A 13-year-old woman presented with a 12-day history of fever accompanied by left axillary lymphadenopathy.
Initial examination was negative except for spiders in the left hand.
Initial laboratory data included: leukocytes 4,700 (32% lymphocytes; 9% monocytes and 51% granulocytes); VSG 14 mm/h; CRP 2.4 mg/dl; negative blood culture.
3 days after the fever persists and the presence of adenopathy was suspected Cat Scratch Disease, Bartonella henselae serology was performed and treatment with rifampicin was initiated after the fever disappeared.
The diagnosis was confirmed after positive serology to Bartonella henselae.
