LAUSR

Cat scratch disease (CSD) is caused by infection with Bartonella henselae, a gram-negative bacterium. Cat scratch disease most often affects children living in the southern United States and is typically spread by cat hosts.1 Symptoms of infection can include prolonged fever and regional aggressive lymphadenopathy, marked by granulomatous inflammation in affected lymph nodes.2,3 The medical diagnosis of CSD can be challenging due to the time it takes for antibody titers to peak in some patients.4 Pathologic diagnosis requires surgical specimen and can be challenging due to difficulty with the staining process for the classic Warthin-Starry stain.3,5,6 Antibiotic treatment of localized cases of CSD is not always indicated, but can be helpful when symptoms are persistent, severe, or the patient is immunocompromised. We present a case of a 7-year-old girl with prolonged cervical neck swelling with protracted clinical illness due to difficulty of diagnosis.