Bilateral Cavitary Pulmonary Nodules Revealing Cat Scratch Disease in a Smoker with COPD: A Case Report

Cat scratch disease (CSD), caused by Bartonella henselae, is typically a benign and self-limiting condition in immunocompetent individuals [1]. Pulmonary involvement is exceedingly rare, especially in the form of bilateral cavitary nodules. We report the case of a 51-year-old woman with a history of smoking-related chronic obstructive pulmonary disease (COPD), who presented with progressive bilateral cavitary pulmonary nodules. Positron emission tomography (PET) demonstrated moderate FDG uptake, raising concern for malignancy. A CT-guided biopsy of a basal left nodule revealed granulomatous inflammation with necrosis, and PCR confirmed the presence of Bartonella henselae, consistent with cat scratch disease. This case highlights an unusual pulmonary presentation of CSD, mimicking metastatic or infectious etiologies, and emphasizes the importance of histological and microbiological confirmation in atypical radiologic findings.