CTICasesDisseminated Bartonella henselae
Imaging findings
Initial chest CT shows symmetric 2-3 mm centrilobular nodules in the lower lobes and necrotizing hilar lymphadenopathy. Following a VATS lung biopsy, the patient rapidly progressed to severe ARDS/DAD. Sero-positivity and autopsy confirmed disseminated Bartonella henselae (cat scratch disease).
Key takeaways
Bartonella henselae typically causes localized lymphadenopathy but can disseminate in patients with underlying comorbidities (like diabetes and cirrhosis), presenting with diffuse pulmonary nodules, splenic lesions, and potentially fatal ARDS.
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