Clinical Report: Mediastinal Lymphadenitis Due to Bartonella henselae in a Child
Background
Cat-scratch disease, caused by Bartonella henselae, typically presents with regional lymphadenopathy in children. However, atypical presentations, such as mediastinal lymphadenitis, can mimic malignancy and lead to airway compression.
Data Highlights
No numerical data or trial data provided in the article.
Key Findings
A 6-year-old boy presented with persistent fever, cough, and weight loss.
Bronchoscopy showed severe bronchomalacia with 90% luminal narrowing of the bronchus.
Initial antimicrobial therapy did not improve symptoms or imaging findings.
Diagnosis of cat-scratch disease was confirmed via metagenomic next-generation sequencing.
Treatment with doxycycline and rifampin resulted in rapid resolution of symptoms and imaging abnormalities.
Clinical Implications
Cat-scratch disease should be considered in the differential diagnosis of pediatric mediastinal masses, particularly when there is a history of cat exposure.
Conclusion
Bartonella henselae infection can present as a necrotic mediastinal mass with severe airway compression in children.
Heart rate monitoring and atrial fibrillation detection had the strongest supporting evidence, but investigators found limited evidence for broader outpatient self-monitoring applications.
