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PubMed2006

Multifocal osteomyelitis in a child: a rare manifestation of cat scratch disease: a case report and systematic review of the literature.

We present a case of a 9-year-old immunocompetent girl who presented with pain in her left elbow and a painful swelling at her left clavicle. She had no lymphadenopathy or fever. Four hot spots were seen at her left clavicle, proximal and distal left humerus and lumbo-sacral spine on a bone scan. A magnetic resonance imaging showed an inflammatory process with bone destruction at her clavicle. Serological testing and polymerase chain reaction performed on a bone biopsy identified a Bartonella henselae infection. She was treated with rifampin and trimethoprim-sulphamethoxazole. After a relapse half a year later, the patient recovered fully. Multifocal osteomyelitis is a rare manifestation of cat scratch disease in children.

Anti-Bacterial Agents↗
PubMed1996

[Cat scratch disease. Bartonella henselae antibodies and DNA detection in regional lymphadenopathy].

HISTORY AND CLINICAL FINDINGS: Two hard, pressure-sensitive nodules developed in the lower jaw of a 22-year-old woman. After a dental cause had been excluded, she was treated for suspected tonsillitis with Ceftibuten. Erythrocyte sedimentation rate was increased to 18 mm in the first hour. There were no other significant biochemical findings and fine-needle biopsy of one of the nodules showed nonspecific inflammatory reaction. INVESTIGATIONS: Sonography revealed two lymph nodes, 7 and 22 mm in diameter. Suspected cat scratch disease was confirmed by immunofluorescence with Bartonella (Rochalimaea) henselae and quintana antigens. TREATMENT AND COURSE: After a course of Clarithromycin (250 mg twice daily) for 6 weeks the lymph nodes had shrunk and the overlying skin was thin and discoloured brown. One node was incised and drained and the material examined. Microbiology was negative, but DNA sequencing confirmed Bartonella henselae. As a consequence, Rifampicin was given for 2 months (600 mg daily). Wound healing was very slow and the scar had regressed little after 9 months.

Adult↗