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Table 2 Clinical characteristics of 5 patients presented atypical form of B. henselae infection

From: The significance of Bartonella henselae bacterias for oncological diagnosis in children

Age (years)/Sex Clinical Features Contact with cat Radiological imagination ELISA test (IgG/ratio) The PCR made from the exceed material Treatment
6/M Enlargement of parotid gland in the left side. The gland was not painful but hard with the diameter 3 cm scratched in the left eyelid USG: solid, hypoechogenic lesion inside the parotid gland suggested neoplastic lesion. (Fot.3) 1: 512 positive Claritromycin, surgical removing, trimetoprim/sulfametoxazol
2/M Fever, arthralgia, generalized lymphadenopathy, left submandibular tissue inflammation, disseminated, tuberous lesions on the skull. Cat at home MRI imagination: the disseminated, pathological infiltration of the both parietal and left frontal bones with osteollysis, settled into the skull with not interrupted pachymeninx. The radiological suggestion: histicytosis. 1:256 - Clindamycin, clarytromycine, ceftazydym), surgical biopsy
USG: left submandibular lymphadenopathy sized 20 × 15 mm.
7/M Fever, local, cervical lymphadenopathy. The painful tumor on the occipito-parietal left area on the skull. No CT imagination: the local, pathological infiltration of the bones in the ocipitoparietal border without pachmeninx interruption 1:512 positive Clindamycin, clarytromycin, surgical biopsy
12/F The local, right axillary and ulnary lymphadenopathy with high fever. After 5–6 weeks the painful tumor on the right parietal area appeared. scratched in the right hand MRI imagination: the local, pathological infiltration of the parietal bone, settled into the skull with not interrupted pachymeninx. The radiological suggestion: histicytosis (Fig. 4). 1:1024 positive Claritromycin, surgical biopsy, azitromycin, trimetoprim/sulfametoxazol
5/M Severe headache, fever and torticollis. The physical examination presented the limitation of the head movements, mild enlargement of the left cervical lymph nodes No USG: left submandibular and cervical lymphadenopathy and hypoechogenic lesion sized 21 × 22 mm located medially to the big neck vessels. 1:512 positive Ceftriakson, surgical biopsy
MRI: the solid mass sized 20 × 14 × 30 mm in the peripharyngeal area modulated the left neck vessels and left tonsils. The lesion presented diffusion restriction in DWI MRI (Fig. 5)