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Role of Whole-Body MR with DWIBS in child's Bartonellosis
Abstract:
Cat-scratch disease (CSD) is a zoonosis in children, result of infection by Bartonella henselae, a gram-negative bacillus. Infection is generally characterized by regional and self-limited lymphadenopathy after exposure to a scratch or bite from a cat. Rarely, B. henselae is cause of fever of unknown origin (FUO), with dissemination to various organs, most often involving the reticuloendothelial system (liver, spleen, bone marrow), mimicking an inflammatory rather than a lymphoproliferative disease. Whole-body Magnetic Resonance Imaging (WBMRI), in association with diffusion-weighted imaging (DWIBS), allows a comprehensive evaluation of pediatric patients, without the risks inherent to ionizing radiation. It is a rapid and sensitive method for detecting and monitoring multifocal lesions such as proliferative or inflammatory and infectious processes. We report a case of systemic CDS in an immunocompetent young boy with fever of unknown origin, without history of cat contact, investigated by WBMRI.
Insights
Cat-scratch disease (CSD) in children, caused by Bartonella henselae, can present as fever of unknown origin. Whole-body MRI with DWIBS effectively diagnosed systemic CSD in a boy without typical cat exposure history.
Area of Science:
- Pediatric Infectious Diseases
- Medical Imaging
- Microbiology
Background:
- Cat-scratch disease (CSD) is a zoonotic infection in children caused by Bartonella henselae.
- Typically presents as lymphadenopathy, but can rarely manifest as fever of unknown origin (FUO) with systemic dissemination.
- Bartonella henselae mimics inflammatory diseases, complicating diagnosis in immunocompetent children.
Observation:
- A case of a young, immunocompetent boy with FUO and systemic CSD is presented.
- The patient had no history of cat contact, a common CSD transmission route.
- Whole-body Magnetic Resonance Imaging (WBMRI) with diffusion-weighted imaging (DWIBS) was utilized for investigation.
Findings:
- WBMRI with DWIBS provided a comprehensive evaluation of the pediatric patient.
- This imaging technique is rapid, sensitive, and avoids ionizing radiation risks.
- It effectively detected multifocal lesions indicative of systemic CSD.
Implications:
- WBMRI with DWIBS is a valuable tool for diagnosing atypical systemic CSD in children.
- This imaging modality aids in identifying disseminated Bartonella henselae infections.
- It offers a safe and effective alternative for evaluating pediatric patients with FUO.
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