Costal osteomyelitis due to <i>Bartonella</i> <i>henselae</i> in a 10-year-old girl

Abstract

Abstract. Bartonella henselae is the bacterial agent responsible for cat scratch disease. This infection is frequently the cause of localized lymphadenitis in children. It is also sometimes responsible for endocarditis, encephalitis, hepatic peliosis and in rare cases osteomyelitis. We describe the second known case of unifocal thoracic osteomyelitis in a 10-year-old child.

Cat-scratch disease: a rare cause of osteomyelitis

“…As such, fever and bone pain that develop during typical CSD, must raise suspicion towards a diagnosis of B. henselae osteomyelitis 15. However, these unspecific clinical features overlap with those of malignant disease, so that bone and soft tissue tumours are usually among the differential diagnoses of atypical CSD,7 8 16 as initially suspected in our patient, whose clinical evaluation started by exclusion of a neoplastic process.…”

“…In its typical form, CSD is a rather frequent disease 1 7. Nonetheless, it is commonly underdiagnosed due to its unspecific clinical presentation and spontaneous evolution towards resolution 8 9.…”

“…Atypical forms of CSD are due to haematogenous, lymphatic or contiguous spread of B. henselae , which may target any organ in the human body; these are infrequent, and osteomyelitis is one of the rarest, occurring predominantly in children and independently of their immunological status 7 8 12. Opposite to haematogenous pyogenic osteomyelitis, which is usually acute and affects the appendicular skeleton, B. henselae osteomyelitis typically impacts the axial skeleton, subacutely in a single spot 8 11 13.…”

Cerebral venous sinus thrombosis and skull base osteomyelitis as manifestations of cat‐scratch disease in a pediatric patient: A case report and literature review

“…The length of therapy for CSD osteomyelitis remains unclear and current practice is based on case reports, small series, and personal experience. In a literature review of 62 cases of B. henselae osteomyelitis in children published since 1954, the length of treatment varied from 5 to 99 days (median: 22 days) 43 . Atypical manifestations of CSD, including osteomyelitis, generally have a self‐limited nature, and good prognosis.…”

“…In a literature review of 62 cases of B. henselae osteomyelitis in children published since 1954, the length of treatment varied from 5 to 99 days (median: 22 days). 43 Atypical manifestations of CSD, including osteomyelitis, generally have a selflimited nature, and good prognosis. 4 | CONCLUSION Bartonella spp.…”