Vertebral Osteomyelitis Due to<i>Bartonella henselae</i>in Adults: A Report of 2 Cases

Verdon, Renaud; Geffray, L.; Collet, Thierry; Huet, H.; Parienti, Jean‐Jacques; Debruyne, Monique; Vergnaud, M.; Bazin, C.

doi:10.1086/344791

Cited by 22 publications

(12 citation statements)

References 35 publications

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“…B. henselae serology and PCR are very useful current tools to confirm CSD osteomyelitis. Serology was positive in most of the CSD osteomyelitis cases (13,14,18,21). Serology in our case was done by indirect immunofluorescence, and the cutoff values for positive serology were at a dilution of 1/128 for IgG and of 1/64 for IgM (7).…”

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confidence: 74%

“…Serology in our case was done by indirect immunofluorescence, and the cutoff values for positive serology were at a dilution of 1/128 for IgG and of 1/64 for IgM (7). Positive PCR has been reported in only two lymph nodes and in six osseous tissues of CSD osteomyelitis (6,10,13,14,17,18,21). In our case, we tested both the osseous and the lymph node materials.…”

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confidence: 77%

“…Osteomyelitis associated with CSD occurs mainly in children (13,18). So far, there have only been four reports of CSD osteomyelitis in immunocompetent adults (12,14,21,22). It can affect any bones, including the vertebrae.…”

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confidence: 99%

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Osteomyelitis Caused by Bartonella henselae Genotype I in an Immunocompetent Adult Woman

Woestyn¹,

Moreau²,

Munting

et al. 2003

J Clin Microbiol

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We report the first description of osteomyelitis due to Bartonella henselae genotype I in an immunocompetent middle-aged woman. The diagnosis was established by serology, histopathology, and PCR analysis of osseous and lymph node tissues. The mycobacteria growth indicator tube inoculated with the lymph node aspirate was used for PCR analysis. CASE REPORTA 62-year-old woman presented with a 2-week history of cervical column tumefaction. She complained of severe pain in the cervical column with radiation of the pain and paresthesia in both arms. She had intermittent fevers and night sweats. Her medical history included an epithelioma of the psoas treated by radiotherapy at age 49 and an endometrial carcinoma treated by surgery and radiotherapy at age 50. She was initially taking no medication. She lived in Belgium and owned about 20 cats.Clinical examination revealed a left cervical tumefaction. The remainder of the examination, including the neurological one, revealed no abnormalities. Hemoglobin and leukocyte levels were normal. C-reactive protein level was elevated, at 12.3 mg/liter. Tumor markers were normal. HIV serology was negative. Ultrasound of the cervical tumefaction suggested a buildup of necrotic lymphadenopathies. A computed tomography scan showed the presence of a paravertebral mass with involvement of the C5 and C6 cervical vertebrae, suggestive of metastatic infiltration. In view of her past medical history, the initial diagnosis was a recurrence of her endometrial carcinoma. A needle aspiration of the cervical tumefaction was undertaken. Histological examination showed necrotizing granulomatous inflammation indicative of cat scratch disease (CSD). Serological testing done by indirect immunofluorescence on Bartonella henselae slides commercialized by Focus Technologies (Cypress, California) was positive for immunoglobulin G (IgG), with a titer at 256. Magnetic resonance imaging (MRI) performed a few days later showed spondylitis with diskitis of the C5 and C6 vertebrae, phlegmona at the same level, and left cervical lymphadenopathies suggestive of tuberculosis. A Mantoux test was negative. Chest radiography was normal. Mycobacterial cultures from the feces and the gastric liquid were made. The patient was discharged with a suspicion of Mycobacterium tuberculosis infection. The C-reactive protein level was at 80 mg/liter, and the white blood cell count was 14.8 ϫ 10 9

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Osteomyelitis Caused by Bartonella henselae Genotype I in an Immunocompetent Adult Woman

Woestyn¹,

Moreau²,

Munting

et al. 2003

J Clin Microbiol

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“…Osteomyelitis in association with CSD is a very rare disease in immunocompetent adults (23,25,50,52). In our study the one patient with this condition was a 62-year old immunocompetent woman (patient 3) who presented with cervical osteomyelitis and two subsequent episodes of cervical lymphadenopathy.…”

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confidence: 99%

Study of Genotypes andvirB4Secretion Gene ofBartonella henselaeStrains from Patients with Clinically Defined Cat Scratch Disease

Woestyn¹,

Olivé²,

Bigaignon³

et al. 2004

J Clin Microbiol

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Bartonella henselae is the causative agent of cat scratch disease (CSD), which usually presents as a selflimiting lymphadenopathy. Occasionally, the bacteria will spread and be responsible for tissue and visceral involvement. Two B. henselae genotypes (genotypes I and II) have been described to be responsible for uncomplicated CSD on the basis of 16S rRNA sequence analysis. A type IV secretion system (T4SS) similar to the virulence-associated VirB system of Agrobacterium tumefaciens was recently identified in the B. henselae Houston-1 genotype I strain. We studied the correlations of the B. henselae genotypes with the clinical presentations and with the presence of T4SS. Isolates originated from CSD patients whose lymph nodes were prospectively analyzed. B. henselae genotype I was identified in 13 of 42 patients (30%). Among these, two teenage twins presented with hepatosplenic CSD and one immunocompetent adult presented with osteomyelitis. Genotype II was detected in 28 of 42 patients (67%), all of whom presented with uncomplicated CSD. The last patient was infected with both genotypes. T4SS was studied by PCR amplification of the virB4 gene. Amplification of virB4 codons 146 to 256, 273 to 357, and 480 to 537 enabled us to detect 66, 90, and 100% of the B. henselae isolates, respectively. Sequence analysis revealed sequence variations that correlated with genotype distribution. Our studies suggest that B. henselae genotype I strains harbor virB4 genes that are different from those harbored by genotype II strains and that genotype I strains might be more pathogenic.

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“…Because of the development of new diagnostic procedures such as polymerase chain reaction (PCR) analysis of biopsy samples, including lymph node aspirates, and serological assays, patients with not only lymphadenopathy but also prolonged fever of unknown origin and involvement of the central nervous system, liver, spleen, bone, eyes, and skin can be diagnosed with CSD. 2 Recently, reports of osteomyelitis due to B. henselae have increased; [3][4][5] and all the previthe region where she lived and at the time when she developed the fever. Laboratory fi ndings showed slight anemia without any increase in white blood cells in peripheral blood.…”

Section: Introductionmentioning

confidence: 99%

Multifocal osteomyelitis due to Bartonella henselae in a child without focal pain

Kodama

Maeno

Nishi

et al. 2007

Journal of Infection and Chemotherapy

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Vertebral Osteomyelitis Due toBartonella henselaein Adults: A Report of 2 Cases

Cited by 22 publications

References 35 publications

Osteomyelitis Caused by Bartonella henselae Genotype I in an Immunocompetent Adult Woman

Osteomyelitis Caused by Bartonella henselae Genotype I in an Immunocompetent Adult Woman

Study of Genotypes andvirB4Secretion Gene ofBartonella henselaeStrains from Patients with Clinically Defined Cat Scratch Disease

Multifocal osteomyelitis due to Bartonella henselae in a child without focal pain

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