Bartonella henselae mediastinal lymphadenitis mimicking malignancy with critical airway compression in a child: a case report
By
Tong Lu
Sijuan Sun
Teng Teng
Jian Zhang
Qing Cao
Hong Ren
June 24, 2026
Clinical Scorecard: Mediastinal Lymphadenitis Due to Bartonella henselae in a Child: A Case of Airway Compression Resembling Cancer
At a Glance
Category Detail
Condition Cat-scratch disease Key Mechanisms Infection by Bartonella henselae leading to necrotizing mediastinal lymphadenitis. Target Population Children, particularly those with exposure to cats. Care Setting Pediatric emergency and inpatient care.
Key Highlights
Cat-scratch disease can present as necrotic mediastinal lymphadenitis mimicking malignancy. Severe airway compression may occur despite mild respiratory symptoms. Diagnosis was established through histopathology and metagenomic sequencing. Initial antimicrobial therapy was ineffective; treatment with doxycycline and rifampin was successful. Integration of imaging, bronchoscopy, and pathology is crucial for accurate diagnosis. Guideline-Based Recommendations
Diagnosis
Consider cat-scratch disease in differential diagnosis of pediatric mediastinal masses. Utilize imaging, bronchoscopy, and molecular testing for diagnosis. Management
Initiate appropriate antimicrobial therapy based on pathogen identification. Monitoring & Follow-up
Monitor for resolution of symptoms and radiologic improvement post-treatment. Risks
Misdiagnosis as malignancy may lead to unnecessary interventions. Patient & Prescribing Data
Previously healthy children with cat exposure.
Doxycycline and rifampin led to prompt resolution of symptoms and airway compression.
Clinical Best Practices
Assess for history of cat exposure in children with mediastinal masses. Perform multidisciplinary evaluations for suspected malignancies. Related Resources & Content
