Cat-scratch disease, common in childhood, typically presents with tender lymphadenopathy. History of cat exposure supports suspicion, confirmed by a positive serologic test for Bartonella henselae. Ultrasound reveals a hypoechoic lobular or oval mass with central hyperemia, adjacent fluid collection, and surrounding edema, aiding differentiation from other causes of lymphadenopathy. A 7-year-old girl with axillary lymphadenopathy, despite no recent cat exposure history, showed sonographic findings suggestive of cat-scratch disease. Serology confirmed B. henselae, and later recall revealed a kitten scratch incident six months prior.
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