Cat-scratch disease of the head and neck in a pediatric population: surgical indications and outcomes.

Abstract

OBJECTIVE:

To identify the presentation of pediatric patients with head and neck manifestations of cat-scratch disease, one of the most common causes of subacute or chronic lymphadenitis in children, and to determine surgical indications and outcomes.

STUDY DESIGN:

Case series.

SUBJECTS AND METHODS:

All pediatric patients from infancy to age 19 years who presented with clinical symptoms of cat-scratch disease and had an IgG serological test result of more than 1:128 for Bartonella henselae.

RESULTS:

Nine patients had cat-scratch disease of the head and neck. Median age at presentation was 4 years; median time from symptom onset to presentation was 20 days. Six (67%) children underwent surgical procedures, and median time from presentation to surgical procedure was 43 days.

CONCLUSION:

Despite conservative treatment, a minority of pediatric patients with cat-scratch disease may require surgical drainage of abscess and removal of lymph nodes. Surgical treatment provides tissue for diagnosis, is generally well tolerated, affords improved recovery, and has minimal complications.

• Authors: Patrick D Munson, Thomas G Boyce, Diva R Salomao, Laura J Orvidas
• Journal: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (Otolaryngol Head Neck Surg) Vol. 139 Issue 3 Pg. 358-63 (Sep 2008) ISSN: 0194-5998 [Print] England
• PMID: 18722212 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents
• Azithromycin

Topics

• Adult
• Anti-Bacterial Agents (administration & dosage)
• Azithromycin (administration & dosage)
• Cat-Scratch Disease (diagnosis, pathology, surgery)
• Child
• Child, Preschool
• Female
• Humans
• Lymph Node Excision
• Male
• Retrospective Studies
• Treatment Outcome