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

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.