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Cat scratch disease presenting with peripheral facial nerve paralysis

R S Walter1, S C Eppes

  • 1Division of General Pediatrics Department of Pediatrics Thomas Jefferson University duPont Hospital for Children, Wilmington, DE 19899, USA.

Pediatrics
|May 13, 1998
PubMed
Summary

Facial nerve paralysis can occur with Cat Scratch Disease (CSD), a bacterial infection. This case report details the first instance of facial paralysis in a child with CSD and swollen lymph nodes.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Acquired peripheral facial nerve paralysis is common, with idiopathic (Bell's palsy) and infectious causes being most frequent.
  • Cat Scratch Disease (CSD), caused by Bartonella henselae, typically presents as lymphadenitis in children and young adults.
  • Atypical CSD presentations include Perinaud's oculoglandular syndrome and acute encephalopathy.

Observation:

  • This report describes a pediatric patient with serologically confirmed Cat Scratch Disease.
  • The child presented with typical lymphadenitis associated with CSD.
  • The patient also developed acute peripheral facial nerve paralysis.

Findings:

  • This represents the first documented case of acute facial nerve paralysis in a child with Cat Scratch Disease and concurrent lymphadenitis.

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  • The findings suggest a potential neurological complication of CSD previously not widely recognized.

    • Implications:

    • This case expands the spectrum of known CSD manifestations.
    • It highlights the importance of considering CSD in the differential diagnosis of pediatric facial nerve paralysis, especially in the presence of lymphadenitis.
    • Further research may be warranted to understand the mechanism and incidence of this neurological complication.