Shaking and Aching: Status Epilepticus After 2 Weeks of Limping

Abstract

This is the case of an 11-year-old girl who presented to the emergency department in status epilepticus. The patient had a 2-week prodromal illness of intermittent fevers, malaise, right lower quadrant pain, and right hip pain. Prior laboratory and radiographic evaluations had yielded no etiology for her symptoms. An in-depth social history revealed a recent cat scratch, and bedside ultrasound identified right-sided deep inguinal lymphadenopathy. The suspected diagnosis of Bartonella encephalopathy was confirmed by serology. This report reviews the broad differential for seizures and highlights the importance of a thorough history to provide direction. Additionally, atypical manifestations, diagnosis, and treatment recommendations of cat-scratch disease are reviewed.