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J Infect. 2006 Nov 28;
Bone infection in cat-scratch disease: A review of the literature.Hajjaji N, Hocqueloux L, Kerdraon R, Bret L.
Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Regional - La Source, BP 86709, 45067 Orleans Cedex 2, France.
OBJECTIVE: To describe the main features of bone infection associated with Cat-scratch disease (CSD).
METHODS: We searched for articles indexed in the international literature databases by using the following key words: "Bartonella", "bone", "cat-scratch", "osteomyelitis" and "osteolytic".
RESULTS: Cases of 47 patients were reviewed. The median age was 9years, with an equal sex distribution. Bone pain and fever were the main symptoms. The presence of fever and increased age were more common in patients with bone infection than classically reported in uncomplicated (i.e. nodal) CSD. The vertebral column and pelvic girdle were the most common sites of infection. Radiological examination typically confirmed bone osteolysis. All patients recovered without complications or chronic infection, although they received a various combination antibiotic regimen and duration therapy. The mechanism by which infection might spread to the bone is via the haematogenous route, accounting for most of the disseminated cases and via the lymphatic route, for those with regional limited extension.
CONCLUSIONS: Bone infection is rare but should be considered when bone pain and fever are present in a patient with nodal CSD. The prognosis is good, whatever treatment is given. Thus bone biopsy should be recommended only in a difficult diagnostic setting, when other bacteria or malignant disease are suspected.
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Pediatr Infect Dis J. 2006 Dec;25(12):1177-1181
Transient Paresis Associated With Cat-Scratch Disease: Case Report
and Literature Review of Vertebral Osteomyelitis Caused by Bartonella
henselae.
* Vermeulen MJ,
* Rutten GJ,
* Verhagen I,
* Peeters MF,
* van Dijken PJ.
From the Departments of *Pediatrics, daggerNeurosurgery, and section
signMicrobiology, St. Elisabeth Hospital, Tilburg, The Netherlands.
Cat-scratch disease (CSD) rarely presents as vertebral
osteomyelitis. We describe a case with paresis of the arm with total
recovery after antibiotic and neurosurgical therapy. We reviewed 20
other cases of CSD vertebral osteomyelitis in the literature. This
diagnosis should be considered in patients with systemic symptoms, back
pain, and cat contact. The prognosis is generally good.
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