Chest Imaging of a rare case of cat-scratch disease in a 2-years-old baby

Abstract

Cat-scratch disease (CSD) is usually a self-limiting infection that in the majority of cases occurs as lymphadenitis in children who have been scratched or bitten by a cat. Rarely, Bartonella henselae is cause of fever of unknown origin (FUO), with dissemination to various organs, mimicking an inflammatory rather than a lymphoproliferative disease. This manuscript will present a case of thoracic manifestations of CSD in an immunocompetent 2-years baby without history of cat contact, with fever of unknown origin, investigated by chest CT and MRI.

Figure 1.

On the left side, Chest X-Ray (anterior-posterior projection), shows a large pulmonary consolidation in the upper right lobe. Notice the widened mediastinum on the right. On the right side see coronal reformatted CT images (A,B) showing a large perilar consolidation involving the upper right lobe, without air bronchogram. C. Axial contrast-enhanced CT image reveals a large soft tissue attenuation mass occupying the mediastinal space

Figure 2.

MR imaging shows a solid and homogenous mediastinal mass characterized by high signal intensity on T2-weighted (A) sequence, DWIBS (B) sequence and STIR images (C). D. Shows the enhancement of mediastinal mass after gadolinium injection on suppressed T1-weighted images