Abnormal Presentation of Bartonella henselae Encephalopathy in a Pediatric Patient.

Cat scratch disease (CSD) is a zoonotic infection caused by the transmission of gram-negative bacteria through a scratch or bite of a feline carrying infected fleas. CSD often presents clinically as a self-limited flu-like infection with painful regional lymphadenopathy appearing one to two weeks following initial transmission. However, a growing body of literature highlights abnormal presentations of infections within the pediatric population. In this case report, we describe an atypical presentation of a infection in an 11-year-old female with seizures, prolonged encephalopathy, agitation, and truncal instability. With an atypical presentation, a delay in diagnosis can result in potentially permanent organ damage, particularly as traditional empiric antibiotics fail to cover infections. As such, proper treatment and complete resolution of symptoms require astute clinical recognition to make the correct diagnosis promptly.