Cat-scratch disease encephalitis. Section. Paediatric radiology. Case Type. Clinical Cases. Authors. Prat-Matifoll J.A, Barber Martinez de la ...HomeAdvancedSearchTeachingCasesQuizzesFAQsContactUsHistorySubmitaCaseAboutUsHomeAdvancedSearchCase13381CASE13381Publishedon29.04.20160Cat-scratchdiseaseencephalitisSectionPaediatricradiologyCaseTypeClinicalCasesAuthorsPrat-MatifollJ.A,BarberMartinezdelaTorreI,DelgadoI,ÁngelSánchez-MontañezGarcía-Carpintero,ElidaVázquezVallHebronHospital,InstitutCatalàdelaSalut,Radiology;PasseigVallHebrón116-11908035Barcelona,Spain;Email:joanalbertpratrx@gmail.comConnectedauthorsJoan-AlbertPratMatifollSpainPatient8years,maleCategoriesAreaofInterestHeadandneck,Liver,Abdomen,Spleen;ImagingTechniqueMR-Diffusion/Perfusion,Ultrasound,CT,Ultrasound-ColourDopplerProcedureImagingsequences,Education,Localisation;SpecialFocusAcute,Abscess,Infection;ShowmoreShowlessDownloadasPDFPrintShowrelatedcasesNotifyadminClinicalHistoryAn8-year-oldboypresentedtotheERwithatonic-clonicconvulsivestatuswhichstartedwhileplayingvideogames.Previousrelevantmedicalhistoryincludedachronicsuppurativeotitisandaclinicallysuspectedmuscularfibrillarruptureintherightinguinalarea.ImagingFindingsAnunenhancedbrainCTwasobtainedandconsiderednormal(Fig.1)Aftercarefulphysicalevaluation,anerythematouslumpintherightinguinalareawasfoundwhichwasnotconsistentwithafibrillarrupture.Sonographyrevealedahypoechoicroundedlesionwithvascularhilumcloselyrelatedtoasubcutaneouscollection(withfluiddrainagetotheskin),compatiblewithsuppurativeinflammatorylymphadenopathy(Fig.2).Additionally,abdominalUSrevealedmultiplehypoechoicandroundedsmalllesions(<1cm)affectingliverandspleen(Fig.3,4,7).Duetopersistentencephalopathicbehaviour,abrainandliverMRIwasperformed.BrainMRIshowedsignalabnormalityonDWIinmultiplecorticalareaswithoutrestricteddiffusionontheADC.Thiswouldbeinkeepingwithfocalareasofcerebraloedema.(Fig.5).LiverMRIconfirmedthepresenceofmultipleT2-hyperintenselesionsshowingrestricteddiffusion,compatiblewit