Cat-Scratch Fever Associated with an Osteolytic Lesion

Collipp, P.J.; Koch, Richard

doi:10.1056/nejm195902052600606

Cited by 34 publications

(8 citation statements)

References 9 publications

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“…All data derived from literature and the current report are summarized in Table 1 . A more detailed table can be found as a supplementary material [ 6 – 37 ] ( available here ).…”

Section: Resultsmentioning

confidence: 99%

Osteomyelitis in Cat-Scratch Disease: A Never-Ending Dilemma—A Case Report and Literature Review

Donà

Fovino

Mozzo

et al. 2018

Case Reports in Pediatrics

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Background We performed a review of published case studies of osteomyelitis associated with cat-scratch disease to consolidate existing information on clinical presentation, diagnostic tools, therapy, and outcome, as well as presenting a case of disseminated cat-scratch disease in a 12-year-old female with skull osteomyelitis and spleen involvement. Methods A search for articles indexed in PubMed, Embase, and Google Scholar was performed with the search terms “Bartonella,” “bone,” “osteomyelitis,” “osteolytic,” and “cat-scratch disease” limited to the immunocompetent pediatric population and articles in English. Results 51 cases were identified. The average age was 7.8 years with equal sex distribution. Fever (84.3%), often with a prolonged course (64.7%), and osteoarticular pain (88.2%) were the most common clinical findings. Lymphadenopathy was present in 64.7% of patients. Vertebral body was mainly involved (51.9%). MRI (50%) and bone scintigraphy (48.1%) were favored to confirm osteomyelitis, while serology was the preferred microbiological diagnostic. Various antibiotics were prescribed in combined or sequential regimens, with median duration of therapy of 23 days. About 12.5% of patients did not receive any treatment. Most patients had excellent prognosis; in particular, all patients not receiving any therapy showed complete recovery and no recurrence of symptoms. Conclusions Bartonella henselae should be considered in differential diagnosis of localized lymphadentitis. Osteoarticular pain or limitation during cat-scratch disease in children should always be investigated for bone spreading. Owing to good prognosis, invasive procedures to obtain the bone material should be avoided. Serology is the gold standard diagnostic tool and MRI is the best radiographic technique to define bone and surrounding tissue involvement. Treatment represents a never-ending dilemma: surgical intervention or use of antibiotics is still controversial, and more studies are needed to define the best antimicrobial regimen.

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“…All data derived from literature and the current report are summarized in Table 1 . A more detailed table can be found as a supplementary material [ 6 – 37 ] ( available here ).…”

Section: Resultsmentioning

confidence: 99%

Osteomyelitis in Cat-Scratch Disease: A Never-Ending Dilemma—A Case Report and Literature Review

Donà

Fovino

Mozzo

et al. 2018

Case Reports in Pediatrics

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“…A number of other complications can occur in association with CSD, including ophthalmic manifestations (74); pneumonia and pleural effusion, which occur in 0.2% of patients (101,118); and musculoskeletal manifestations. Osteomyelitis is a rare manifestation, occurring in 0.3% of patients; it may affect any bone (2,34,36,46,172). Occasionally there is a direct extension from an adjacent involved lymph node.…”

Section: Complications Of Cat Scratch Diseasementioning

confidence: 99%

Bartonella spp. as emerging human pathogens

1997

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Members of the genus Bartonella (formerly Rochalimaea) were virtually unknown to modern-day clinicians and microbiologists until they were associated with opportunistic infections in AIDS patients about 6 years ago. Since that time, Bartonella species have been associated with cat scratch disease, bacillary angiomatosis, and a variety of other disease syndromes. Clinical presentation of infection with Bartonella ranges from a relatively mild lymphadenopathy with few other symptoms, seen in cat scratch disease, to life-threatening systemic disease in the immunocompromised patient. In some individuals, infection manifests as lesions that exhibit proliferation of endothelial cells and neovascularization, a pathogenic process unique to this genus of bacteria. As the spectrum of disease attributed to Bartonella is further defined, the need for reliable laboratory methods to diagnose infections caused by these unique organisms also increases. A brief summary of the clinical presentations associated with Bartonella infections is presented, and the current status of laboratory diagnosis and identification of these organisms is reviewed.

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“…Debido a que estas lesiones se asocian también a cierto grado de actividad osteoblástica, predominantemente periférica a la zona lítica y pesquisable a veces con la radiografía en forma de esclerosis 35,46 , el CO es capaz de detectar de manera altamente sensible y precoz un proceso osteomielítico causado por B. henselae. Además del aumento de actividad osteoblástica, la mayor captación del MDP-Tc 99m por las lesiones visible en el CO puede estar relacionada con el importante componente inflamatorio y la necrosis central presente en la biopsia 22,42,46 .…”

Section: Discussionunclassified

Forma atípica de enfermedad por arañazo de gato: Compromiso óseo en dos pacientes pediátricos detectado mediante cintigrafía ósea. Revisión de la literatura

et al. 2003

Rev. chil. infectol.

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Cat-Scratch Disease (CSD) is a benign, self-limited illness that occurs after scratch or bite of a cat carrier of Bartonella henselae. It presents as lymphadenopathy near to the inoculation site, and affects in 80% of cases individual younger that 21 years old. Fewer than 25% of patients will have the atypical form of the disease, with involvement of organs as liver, spleen, central nervous system and retina. Osteomyelitis has been claimed in old series as rare, although more recent publications suggest a higher incidence. Axial skeleton is the most frequently involved, especially pelvis and dorsal and lumbar spine. Skeletal lesions can be only one or multiple. Lesions not always cause pain and they can appear weeks or months after the beginning of symptoms. We describe two girls with skeletal involvement, positive serology for B. henselae and complete recovery. One of them (12 yr) had fever and abdominal pain, with a hypodense lesion in liver and multifocal osteomyelitis in spine and pelvis. The other one (10 yr) had sub-maxillary adenopathy and one painless lesion in iliac crest, which was evident in bone scan (BS), without fever or worsening of general condition. We recommend the regular use of BS in patients with CSD due to poor sensitivity of radiography in detection of bone envolvement and because these lesions can be multifocal and painless in some cases.Key words: Cat-Scratch Disease; Bartonella henselae; Osseous involvement; Osteomyelitis; Bone scan. IntroducciónEl compromiso del aparato locomotor siempre significa un reto para el médico. Sus causas son diversas: desde traumáticas, infecciosas e inflamatorias, a tumorales. Sus manifestaciones clí-nicas son variables, dependiendo de la edad del paciente y su etiología. Con este espectro tan diverso, frente a un niño con síntomas y signos músculo-esqueléticos, nuestro objetivo será siempre descartar un proceso infeccioso o tumoral. Así la patología del aparato locomotor de un recién nacido o un lactante, obligará a descartar como primera posibilidad una osteo-artritis sépti-ca, la cual habitualmente se desarrollará en el contexto de un cuadro infeccioso sistémico 1 . Es diferente en el pre-escolar y escolar, donde surge una gran gama de patologías; los cuadros infecciosos en este grupo etario ya no ocupan el primer lugar y las manifestaciones pueden estar dadas tanto por focalización del microorganismo en el esqueleto, así como ser una respuesta reactiva a la presencia del mismo en el organismo. En ellos, el cuadro clínico puede expresarse como un síndrome febril, con o sin síntomas dolorosos del aparato locomotor. Actualmente, a

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Cat-Scratch Fever Associated with an Osteolytic Lesion

Cited by 34 publications

References 9 publications

Osteomyelitis in Cat-Scratch Disease: A Never-Ending Dilemma—A Case Report and Literature Review

Osteomyelitis in Cat-Scratch Disease: A Never-Ending Dilemma—A Case Report and Literature Review

Bartonella spp. as emerging human pathogens

Forma atípica de enfermedad por arañazo de gato: Compromiso óseo en dos pacientes pediátricos detectado mediante cintigrafía ósea. Revisión de la literatura

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