Cat-scratch disease: an unusual presentation.

A 2-year-old child was found to have mesenteric lymphoadenopathy during investigation of a fever of unknown origin. The lymphadenopathy persisted at follow-up 2 months later. Workup for an infectious etiology was negative. A laparotomy and excisional biopsy was performed to eliminate lymphoma. Pathology showed enlarged lymph nodes containing granulomas with giant cells and central caseating necrosis. Warthin-Starry staining showed cat-scratch bacilli within the necrotic material. Cat-scratch disease is a well-recognized cause of regional adenopathy in children and usually resolves without treatment. Intraabdominal involvement, consisting of hepatic and splenic lesions, often associated with retroperitoneal adenopathy, has been reported. Isolated mesenteric adenopathy is an unusual presentation of this disease but should be included in the differential diagnosis of intraabdominal lymphadenopathy.