Pediatric cervicofacial lymphadenitis caused by Bartonella henselae

Background. Chronic cervicofacial lymphadenitis in children is often caused by nontuberculous mycobacterium or Bartonella henselae species (known as cat scratch disease). Methods. Bartonella henselae infection was diagnosed in 53 of 427 children with cervicofacial lymphadenopathy by polymerase chain reaction. Results. The age of patients ranged from 16 to 148 months (median, 59 months), 28 (53%) were male, and 25 were female (47%). The submandibular lymph nodes were most commonly affected (92%). Patients were not treated with antibiotics. In 11 (21%) patients, aspiration of pus was performed to facilitate drainage, which led to a mean resolution of 5 + 3.1 months compared with a mean resolution time of 8.2 +/- 3.8 months for 40 patients treated with a wait-and-see policy (P = .01). Conclusions. Bartonella henselae is a common pathogen in children with chronic cervicofacial lymphadenitis. Treatment usually involves a wait-and-see approach, but in selected cases, aspiration may be needed for symptomatic relief.