Role of cat-scratch disease in lymphadenopathy in the head and neck.
Bartonella henselae is the causative agent of cat-scratch disease (CSD), which usually manifests as acute regional lymphadenopathy. The causes of cervical lymphadenopathy, with special regard to CSD, were investigated in a study of 454 patients who presented with unclear masses in the head and neck from January 1997 through January 2001. Sixty-one patients (13.4%) experienced CSD; 54 (11.9%) had primary lymphadenopathy due to other infectious agents, and 41 (9.0%) had lymphadenopathy that occurred in association with primary infections of other organs. For 171 patients (37.7%), the cause of the cervical lymph node enlargement could not be found. B. henselae DNA was detected in extirpated lymph nodes only during the first 6 weeks of lymphadenopathy, which indicates that the results of polymerase chain reaction strongly depend on the duration of illness. CSD should be included in the differential diagnosis of adenopathy in the otorhinolaryngologic patient population, to avoid unnecessary treatment.
Department of Otorhinolaryngology-Head and Neck Surgery, University of Freiburg, Freiburg, Germany.
Gerd Jürgen
GJ
Ridder
Carsten Christof
CC
Boedeker
Katja
K
Technau-Ihling
Roland
R
Grunow
Anna
A
Sander
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D018416:Bartonella henselae / Q000235:genetics; D002372:Cat-Scratch Disease / Q000150:complications* / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology; D004269:DNA, Bacterial / Q000032:analysis; D006257:Head; D006801:Humans; D008206:Lymphatic Diseases / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology / Q000382:microbiology; D009333:Neck
D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial