Mujer de 70 años con Lupus Eritematoso sistémico y fiebre de seis semanas de evolución

Abstract

A 70-year-old female with a history of systemic lupus erythematosus who had received a kidney transplant four years before due to lupus nephritis presented to the emergency room with a six-week history of fever and polyarthralgias. She owned a cat and admitted occasional scratches. Physical examination revealed a temperature of 38.2ºC and a nontender erythematous nodule on the left calf region. Laboratory tests revealed slight alteration of acute phase reactants. CT scan of the thorax and abdomen showed enlarged lymph nodes in the right inguinal region. Bartonella serology was positive (IgG 1/64), and a positive result of polymerase chain reaction assays for Bartonella henselae in the exudate of the skin lesion confirmed the diagnosis of cat scratch disease. Treatment was started with doxycycline and clarithromycin with complete resolution of symptoms.