title: The significance of Bartonella henselae bacterias for oncological diagnosis in children.
abstract: BACKGROUND
  Cat-scratch disease (CSD) is a common infection in children; however, the wide spectrum of its clinical picture may lead to delayed diagnosis. An unusual presentation of CSD includes in the differential diagnosis malignant diseases, Epstein-Barr and cytomegalovirus infections, tuberculosis, and mycobacterioses. The diagnostic procedure is difficult, and it is important to consider CSD as the etiology of untypical lesion.
  
  
  METHODS
  We present the analysis of 22 immunocompetent children treated with the clinical diagnosis of CSD in our hospital. Their ages were 2 to 16 years (mean 9.15 ± 2.2 years). Four of them presented classical papulas at admission time. Asymmetric, local lymphadenopathy was present in 16 patients. Five children, who presented an untypical course of CSD mimicking the oncological process, were analysed carefully. There were 3 patients with skull osteomyelitis, 1 with inflammation of the parotid gland, and 1 with an extra peripharyngeal mass. The diagnosis in these children was based on epidemiological, radiological, serological, and histological factors.
  
  
  RESULTS
  About 25 % of children with bartonellosis present an untypical spectrum of symptoms, including the lack of documented cat contact, primary lesions, or peripheral lymphadenopathy. Radiological methods like USG, CT, MRI present the unspecific masses, but they are not enough to distinguish the Bartonella inflammatory and oncological process. The final diagnosis was based on a histological method with additional polymerase chain reaction test.
  
  
  CONCLUSIONS
  CSD should be considered in differential diagnosis of any patient with untypical lesions located on the head, neck, and upper extremities.
authors.affiliation: Department of Infectious Diseases and Child Neurology Karol Marcinkowski University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Mazur-Melewska
authors.affiliation: Pediatric Radiology Department Chair of Radiology Karol Marcinkowski University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Jończyk-Potoczna
authors.affiliation: Department of Infectious Diseases and Child Neurology Karol Marcinkowski University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Mania
authors.affiliation: Department of Infectious Diseases and Child Neurology Karol Marcinkowski University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Kemnitz
authors.affiliation: Pediatric ENT Department, Karol Marcinkowski Poznan University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Szydłowski
authors.affiliation: Department of Infectious Diseases and Child Neurology Karol Marcinkowski University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Służewski
authors.affiliation: Department of Infectious Diseases and Child Neurology Karol Marcinkowski University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Figlerowicz
keywords: Bartonella henselae; CSD; Children