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Otufowora A, Lee C, Mohideen A, DeSena G, Pringle C, Guyer F, Sharma P, Baines T, Carr S. Cerebral venous sinus thrombosis and skull base osteomyelitis as manifestations of cat-scratch disease in a pediatric patient: A case report and literature review. Clin Case Rep 2023; 11:e7561. [PMID: 37361655 PMCID: PMC10288016 DOI: 10.1002/ccr3.7561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/18/2023] [Accepted: 06/02/2023] [Indexed: 06/28/2023] Open
Abstract
Cat-scratch disease (CSD) is caused by Bartonella henselae and usually presents with regional lymphadenopathy. Skull base osteomyelitis and cerebral venous sinus thrombosis are rarely reported, particularly in immunocompetent children. CSD should be considered in the differential diagnosis of any patient with persistent headaches in the setting of cat exposure.
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Affiliation(s)
- Ayodeji Otufowora
- Department of PediatricsCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Christine Lee
- Department of PediatricsCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Aneeb Mohideen
- Department of PediatricsCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Grace DeSena
- Department of PediatricsCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Charlene Pringle
- Department of PediatricsCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Freddie Guyer
- Department of PediatricsCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Priya Sharma
- Department of RadiologyCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Torrey Baines
- Department of PediatricsCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Silvana Carr
- Department of PediatricsCollege of Medicine, University of FloridaGainesvilleFloridaUSA
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Mathkour M, Chu J, Scullen T, Ibrahim N, Werner C, Carr C, Huang B, Abou-Al-Shaar H, Dallapiazza R, Maulucci C, Singh M. Atlantoaxial instability secondary to Bartonella henselae osteomyelitis managed surgically by atlantoaxial instrumentation: A case report and systematic review. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE 2022; 13:224-232. [PMID: 36263337 PMCID: PMC9574113 DOI: 10.4103/jcvjs.jcvjs_206_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 04/19/2021] [Indexed: 11/13/2022] Open
Abstract
Cat scratch disease (CSD), caused by Bartonella henselae, may atypically present with vertebral osteomyelitis. Antibiotic regimens are tailored to presentation, which is markedly variable and not well defined for any atypical disease. In cases of spinal instability, the use of antibiotics alone may not be sufficient. Atlantoaxial instability caused by osteomyelitis is a rare complication of CSD. In this report, we describe the rare case of vertebral osteomyelitis complicated by atlantoaxial instability, requiring both antibiotics and atlantoaxial fusion. We discuss our case, surgical technique, rationale, and outcome. In addition, we conducted a systematic review of the literature of vertebral osteomyelitis in pediatric secondary to B. henselae. A 2-year-old child presented with a 2-month history of irritability, fever, and rigid neck pain along with a recent history of feline exposure. Physical examination revealed cervical tenderness and decreased range of motion. Computed tomography (CT) showed osteolysis of the right C1 lateral mass and pars articularis; T1-weighted magnetic resonance imaging with contrast showed enhancement around the right C1 lateral mass. The titer for B. henselae was high. A diagnosis of cat scratch osteomyelitis with cervical instability was made, for which the patient underwent surgery with atlantoaxial fusion. Postoperative imaging demonstrated resolution of the contrast-enhanced lesion. At 6-year follow-up, the patient showed no signs of residual complications from surgical intervention with a solid fusion. Our review revealed 44 cases of pediatric CSD vertebral osteomyelitis. Conservative management with antibiotic employed in 86% while antibiotics with surgical intervention in 14% of the cases. Surgical intervention was most often in the form of incision for drainage and decompression without fusion. Average follow-up 10 months with 86% achieved complete resolution. Cervical instability caused by osteolysis is a rare complication of CSD. This can subsequently lead to vertebral instability, requiring definitive surgical intervention.
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Salmon-Rousseau A, Auvray C, Besset Q, Briandet C, Desplantes C, Chavanet P. Costal osteomyelitis due to Bartonella henselae in a 10-year-old girl. J Bone Jt Infect 2021; 6:171-178. [PMID: 34109101 PMCID: PMC8182667 DOI: 10.5194/jbji-6-171-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 05/03/2021] [Indexed: 11/13/2022] Open
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.
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Affiliation(s)
| | - Christelle Auvray
- Laboratory of Virology, François Mitterrand University Hospital, Dijon, France
| | - Quentin Besset
- Infectious Diseases Department, Dijon University Hospital, Dijon, France
| | - Claire Briandet
- Department of Pediatric Onco-Hematology, Dijon University Hospital, Dijon, France
| | - Claire Desplantes
- Department of Pediatric Onco-Hematology, Dijon University Hospital, Dijon, France
| | - Pascal Chavanet
- Infectious Diseases Department, Dijon University Hospital, Dijon, France
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Abstract
Cat scratch disease (CSD) is a rare zoonotic infection disease, and the imaging performance for evaluation varies. We present FDG PET/CT images of two cases of CSD. In one case, images showed typical findings of regional lymph node enlargement. In another case, images showed atypical findings of extensive superficial and deep lymph node enlargement.
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Erdem G, Watson JR, Hunt WG, Young C, Tomatis Souverbielle C, Honegger JR, Cassady KA, Ilgenfritz M, Napolitano S, Koranyi K. Clinical and Radiologic Manifestations of Bone Infection in Children with Cat Scratch Disease. J Pediatr 2018; 201:274-280.e12. [PMID: 30041935 DOI: 10.1016/j.jpeds.2018.05.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 05/09/2018] [Accepted: 05/17/2018] [Indexed: 11/17/2022]
Abstract
We identified 13 patients with cat scratch (Bartonella henselae) bone infection among those admitted to a large tertiary care children's hospital over a 12-year period. The median age was 7 years and the median time from onset of illness to diagnosis was 10 days. Multifocal osteomyelitis involving spine and pelvis was common; no patient had a lytic bone lesion. Median treatment duration was 28 days (IQR, 24.5 days). Despite significant variations in treatment duration and antimicrobial therapy choices, all patients showed improvement.
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Affiliation(s)
- Guliz Erdem
- Pediatrics, Nationwide Children's Hospital, Columbus, OH; The Ohio State University College of Medicine, Columbus, OH.
| | - Joshua R Watson
- Pediatrics, Nationwide Children's Hospital, Columbus, OH; The Ohio State University College of Medicine, Columbus, OH
| | - W Garrett Hunt
- Pediatrics, Nationwide Children's Hospital, Columbus, OH; The Ohio State University College of Medicine, Columbus, OH
| | - Cody Young
- The Ohio State University College of Medicine, Columbus, OH; Radiology, Nationwide Children's Hospital, Columbus, OH
| | - Cristina Tomatis Souverbielle
- Pediatrics, Nationwide Children's Hospital, Columbus, OH; The Ohio State University College of Medicine, Columbus, OH
| | - Jonathan R Honegger
- Pediatrics, Nationwide Children's Hospital, Columbus, OH; The Ohio State University College of Medicine, Columbus, OH
| | - Kevin A Cassady
- Pediatrics, Nationwide Children's Hospital, Columbus, OH; The Ohio State University College of Medicine, Columbus, OH
| | - Megan Ilgenfritz
- Pediatrics, Nationwide Children's Hospital, Columbus, OH; The Ohio State University College of Medicine, Columbus, OH
| | - Stephanie Napolitano
- Pediatrics, Nationwide Children's Hospital, Columbus, OH; The Ohio State University College of Medicine, Columbus, OH
| | - Katalin Koranyi
- Pediatrics, Nationwide Children's Hospital, Columbus, OH; The Ohio State University College of Medicine, Columbus, OH
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An Atypical Case of Bartonella henselae Osteomyelitis and Hepatic Disease. Case Rep Pediatr 2018; 2018:2750275. [PMID: 29850344 PMCID: PMC5907520 DOI: 10.1155/2018/2750275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 03/03/2018] [Accepted: 03/22/2018] [Indexed: 11/20/2022] Open
Abstract
Bartonella henselae is a Gram-negative bacterium and the causative agent of cat scratch disease (CSD). Atypical presentations of B. henselae that involve the musculoskeletal, hepatosplenic, cardiac, or neurologic systems are rare. In this case report, we describe a case of B. henselae osteomyelitis involving bilateral iliac bones complicated by hepatic lesions in a 12-year-old immunocompetent female patient. Although B. henselae is a rare cause of osteomyelitis, it should be considered when patients who present with fever, pain, and lymphadenopathy do not respond to routine osteomyelitis therapy.
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Osteomyelitis in Cat-Scratch Disease: A Never-Ending Dilemma-A Case Report and Literature Review. Case Rep Pediatr 2018; 2018:1679306. [PMID: 29808150 PMCID: PMC5902065 DOI: 10.1155/2018/1679306] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 02/15/2018] [Accepted: 03/07/2018] [Indexed: 12/20/2022] Open
Abstract
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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Chen Y, Fu YB, Xu XF, Pan Y, Lu CY, Zhu XL, Li QH, Yu RS. Lymphadenitis associated with cat-scratch disease simulating a neoplasm: Imaging findings with histopathological associations. Oncol Lett 2018; 15:195-204. [PMID: 29399138 PMCID: PMC5766074 DOI: 10.3892/ol.2017.7311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 09/28/2017] [Indexed: 12/26/2022] Open
Abstract
The lymphadenitis associated with cat-scratch disease (CSD) is often confused with neoplasms by a number of radiologists and clinicians, and consequently, unnecessary invasive procedures or surgeries are performed. In the present study, the contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) findings of 10 patients (6 men and 4 women) with clinically and pathologically confirmed lymphadenitis associated with CSD were retrospectively analyzed (CT in 3 patients, MRI in 6 patients, and CT and MRI in 1 patient) at The Second Affiliated Hospital of Zhejiang University School of Medicine (Hangzhou, China) between January 2007 and November 2014. As a result, 17 enlarged lymph nodes were identified in 10 cases. The 5 nodes identified by CT scan exhibited relatively inhomogeneous isodensity to muscle, with patchy low density in the center. All 14 nodes identified by MRI scan exhibited homogeneous or heterogeneous isointensity to muscle or slightly increased intensity compared with that of muscle on T1-weighted images (T1WI), and homogeneous or heterogeneous hyperintensity on fat-suppressed T2WI. Following enhancement, all 17 enlarged lymph nodes associated with CSD demonstrated the following 3 different enhancement patterns: Moderate homogeneous enhancement (n=8), which was associated with histologically identified early disease stage; marked heterogeneous enhancement with no enhancement of the necrotic areas (n=4), and heterogeneous enhancement with progressively ‘spoke-wheel-like’ (defined as radiating enhancement from the center) enhancement of the patchy low-density area (n=1), which was associated with histologically identified intermediate disease stage; and astral low-density/hypointensity with marked enhancement (n=2) or a ‘rose flower’ sign (n=2), which was associated with histologically identified late disease stage. We hypothesized that the CT and MRI results of lymphadenitis in CSD may be associated with the pathological features. It may be suggested that the diagnosis of CSD may be formed when considering the characteristic CT and MRI features of astral low-density/hypointensity with marked enhancement or a ‘rose flower’ sign (defined as marginal petaloid enhancement) in the late disease stage, or the MRI results of homogeneous, moderate enhancement in the early disease stage, or the CT/MRI data of heterogeneous enhancement with non-enhancing area in the center in the intermediate disease stage, in solitary or multiple enlarged lymph nodes associated with general subcutaneous edema in the vicinity of the nodes on CT/MRI and with a history of cat exposure.
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Affiliation(s)
- Ying Chen
- Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Yan-Biao Fu
- Department of Pathology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Xiu-Fang Xu
- Department of Radiology, Hangzhou Medical College, Hangzhou, Zhejiang 310053, P.R. China
| | - Yao Pan
- Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Chen-Ying Lu
- Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Xiu-Liang Zhu
- Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Qing-Hai Li
- Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Ri-Sheng Yu
- Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
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Joychan S, Kuchipudi Y, Danielsky PJ, Bovid KM, Garg D. Case of Nonspinal Osteomyelitis Due to Bartonella and Review of the Literature. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2017. [DOI: 10.1097/ipc.0000000000000511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Puri K, Kreppel AJ, Schlaudecker EP. Bartonella Osteomyelitis of the Acetabulum: Case Report and Review of the Literature. Vector Borne Zoonotic Dis 2016; 15:463-7. [PMID: 26273806 DOI: 10.1089/vbz.2014.1758] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Bartonella henselae commonly involves the mononuclear phagocyte system (MPS), and its most common presentation is lymphadenitis. Rarely, it can cause isolated osteomyelitis. We present a case of a 3 year old with constitutional symptoms and new onset of limp. Previously reported cases of osteomyelitis due to B. henselae are also reviewed here, keeping the index case in mind. METHODS We conducted a Medline search using MeSH subject headings Bartonella and osteomyelitis, limited to humans. RESULTS The index case is a 3-year-old female who had a subacute presentation with new-onset leg pain and fever. Subsequent imaging demonstrated osteomyelitis of the acetabulum. Multiple diagnostic attempts were unsuccessful, and the patient did not respond to empiric therapy. Despite indeterminate serology, the diagnosis of Bartonella osteomyelitis was eventually confirmed by PCR on bone biopsy of the lesion. The literature search revealed 48 publications, which were reduced to 28 when limiting articles to the English language and the pediatric population. After a report of 36 pediatric cases in 2007, there have been an additional 12 pediatric cases since 1998. Generally, these patients had a subacute presentation with relatively mild constitutional symptoms. Most commonly, bone involvement occurred as osteolytic lesions of the axial skeleton. Of the total 48 cases reported, only four reported involvement of the axial skeleton. CONCLUSION We present the first case, to our knowledge, of pediatric osteomyelitis of the pelvis due to B. henselae with indeterminate serologic and positive PCR results. Bartonella osteomyelitis should be included in the differential diagnosis when typical pathogens are not identified or if the patient is slow to respond to standard therapies. The sensitivity of tissue PCR for Bartonella osteomyelitis is now better than the current gold standard of serology, and new management guidelines may need to reflect this.
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Affiliation(s)
- Kriti Puri
- 1 Pediatrics Resident, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio
| | - Andrew J Kreppel
- 2 Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio
| | - Elizabeth P Schlaudecker
- 2 Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio
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Juan Zepeda T, Jorge Morales S, Hugo Letelier A, Luis Delpiano M. [Bartonella henselae vertebral osteomyelitis: report of a case]. ACTA ACUST UNITED AC 2015; 87:53-8. [PMID: 26460082 DOI: 10.1016/j.rchipe.2015.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 06/15/2015] [Accepted: 08/24/2015] [Indexed: 11/17/2022]
Abstract
UNLABELLED Cat scratch disease (CSD) is caused by Bartonella henselae, with unknown prevalence and incidence in the Chilean paediatric population. Regional lymphadenopathy is the most common presentation, while atypical forms constitute a diagnostic challenge. OBJECTIVE To report a case of CSD with osteomyelitis and present guidelines regarding treatment. CLINICAL CASE An eight year-old patient, with prolonged febrile illness, back pain and neck stiffness. Laboratory studies highlight positive IgG for Bartonella henselae. The abdominal ultrasound showed splenic micro-abscesses, and the MRI showing vertebral lesions suggestive of osteomyelitis. DISCUSSION The diagnosis of atypical forms requires a high rate of suspicion, as in this case, in which the patient manifested the musculoskeletal symptoms simultaneously with the febrile syndrome, which led us to study possible complications of the disease. Current knowledge of the treatment of atypical or complicated CSD is derived from the observation of case studies, rather than randomized trials. It is suggested that antibiotic therapy is analysed individually, with the help of a specialist. CONCLUSION The importance of high clinical suspicion are emphasised and discussed, as well presenting some treatment options based on the evidence from the current literature.
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Affiliation(s)
- T Juan Zepeda
- Programa de Especialización en Pediatría, Universidad de Chile, Hospital San Borja Arriarán, Santiago Chile, Chile.
| | - S Jorge Morales
- Interno de Medicina, Universidad Católica del Maule, Talca, Chile
| | | | - M Luis Delpiano
- Servicio de Pediatría, Hospital San Borja Arriarán, Santiago, Chile
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Mazur-Melewska K, Jończyk-Potoczna K, Mania A, Kemnitz P, Szydłowski J, Służewski W, Figlerowicz M. The significance of Bartonella henselae bacterias for oncological diagnosis in children. Infect Agent Cancer 2015; 10:30. [PMID: 26379764 PMCID: PMC4568588 DOI: 10.1186/s13027-015-0025-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 08/19/2015] [Indexed: 12/30/2022] Open
Abstract
Background Cat-scratch disease (CSD) is a common infection in children; however, the wide spectrum of its clinical picture may lead to delayed diagnosis. An unusual presentation of CSD includes in the differential diagnosis malignant diseases, Epstein-Barr and cytomegalovirus infections, tuberculosis, and mycobacterioses. The diagnostic procedure is difficult, and it is important to consider CSD as the etiology of untypical lesion. Patients and method We present the analysis of 22 immunocompetent children treated with the clinical diagnosis of CSD in our hospital. Their ages were 2 to 16 years (mean 9.15 ± 2.2 years). Four of them presented classical papulas at admission time. Asymmetric, local lymphadenopathy was present in 16 patients. Five children, who presented an untypical course of CSD mimicking the oncological process, were analysed carefully. There were 3 patients with skull osteomyelitis, 1 with inflammation of the parotid gland, and 1 with an extra peripharyngeal mass. The diagnosis in these children was based on epidemiological, radiological, serological, and histological factors. Results About 25 % of children with bartonellosis present an untypical spectrum of symptoms, including the lack of documented cat contact, primary lesions, or peripheral lymphadenopathy. Radiological methods like USG, CT, MRI present the unspecific masses, but they are not enough to distinguish the Bartonella inflammatory and oncological process. The final diagnosis was based on a histological method with additional polymerase chain reaction test. Conclusion CSD should be considered in differential diagnosis of any patient with untypical lesions located on the head, neck, and upper extremities.
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Affiliation(s)
- Katarzyna Mazur-Melewska
- Department of Infectious Diseases and Child Neurology Karol Marcinkowski University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland
| | - Katarzyna Jończyk-Potoczna
- Pediatric Radiology Department Chair of Radiology Karol Marcinkowski University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland
| | - Anna Mania
- Department of Infectious Diseases and Child Neurology Karol Marcinkowski University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland
| | - Paweł Kemnitz
- Department of Infectious Diseases and Child Neurology Karol Marcinkowski University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland
| | - Jarosław Szydłowski
- Pediatric ENT Department, Karol Marcinkowski Poznan University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland
| | - Wojciech Służewski
- Department of Infectious Diseases and Child Neurology Karol Marcinkowski University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland
| | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology Karol Marcinkowski University of Medical Sciences, Szpitalna Street 27/33, 60-578 Poznań, Poland
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Maggi RG, Mascarelli PE, Havenga LN, Naidoo V, Breitschwerdt EB. Co-infection with Anaplasma platys, Bartonella henselae and Candidatus Mycoplasma haematoparvum in a veterinarian. Parasit Vectors 2013; 6:103. [PMID: 23587235 PMCID: PMC3637287 DOI: 10.1186/1756-3305-6-103] [Citation(s) in RCA: 143] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 04/09/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND During a two year period, a 27-year-old female veterinarian experienced migraine headaches, seizures, including status epilepticus, and other neurological and neurocognitive abnormalities. Prior to and during her illness, she had been actively involved in hospital-based work treating domestic animals, primarily cats and dogs, in Grenada and Ireland and anatomical research requiring the dissection of wild animals (including lions, giraffe, rabbits, mongoose, and other animals), mostly in South Africa. The woman reported contact with fleas, ticks, lice, biting flies, mosquitoes, spiders and mites and had also been scratched or bitten by dogs, cats, birds, horses, reptiles, rabbits and rodents. Prior diagnostic testing resulted in findings that were inconclusive or within normal reference ranges and no etiological diagnosis had been obtained to explain the patient's symptoms. METHODS PCR assays targeting Anaplasma sp. Bartonella sp. and hemotopic Mycoplasma sp. were used to test patient blood samples. PCR positive amplicons were sequenced directly and compared to Gen Bank sequences. In addition, Bartonella alpha Proteobacteria growth medium (BAPGM) enrichment blood culture was used to facilitate bacterial growth and Bartonella spp. serology was performed by indirect fluorescent antibody testing. RESULTS Anaplasma platys, Bartonella henselae and Candidatus Mycoplasma haematoparvum DNA was amplified and sequenced from the woman's blood, serum or blood culture samples. Her serum was variably seroreactive to several Bartonella sp. antigens. Despite symptomatic improvement, six months of doxycycline most likely failed to eliminate the B. henselae infection, whereas A. platys and Candidatus M. haematoparvum DNA was no longer amplified from post-treatment samples. CONCLUSIONS As is typical of many veterinary professionals, this individual had frequent exposure to arthropod vectors and near daily contact with persistently bacteremic reservoir hosts, including cats, the primary reservoir host for B. henselae, and dogs, the presumed primary reservoir host for A. platys and Candidatus Mycoplasma haematoparvum. Physicians caring for veterinarians should be aware of the occupational zoonotic risks associated with the daily activities of these animal health professionals.
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Affiliation(s)
- Ricardo G Maggi
- Department of Clinical Sciences, Intracellular Pathogens Research Laboratory, Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA
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Abstract
Cat-scratch disease is a bacterial infection caused by Bartonella henselae. Bone involvement is rare. We describe the case of a 7-year-old boy with a systemic form of the disease. He presented with a 15-day history of fever, altered general condition, weight loss and cough, associated with back pain, and right-sided coxalgia. Bone scintigraphy with Tc-99m hydroxymethylene diphosphonate showed spinal involvement, the iliac crest, the right ankle, and the right first metatarsal. Magnetic resonance imaging confirmed these locations. He was positive for anti-Bartonella henselae. The fever regressed before treatment with rifampicin began, and he made a full recovery.
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15
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Rohr A, Saettele MR, Patel SA, Lawrence CA, Lowe LH. Spectrum of radiological manifestations of paediatric cat-scratch disease. Pediatr Radiol 2012; 42:1380-4. [PMID: 22797536 DOI: 10.1007/s00247-012-2451-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Revised: 05/23/2012] [Accepted: 05/24/2012] [Indexed: 01/27/2023]
Abstract
Cat-scratch disease (CSD) is usually a self-limiting condition that may mimic more serious disorders due to its variable clinical and imaging presentations. Many cases are diagnosed throughout the United States annually, with the majority occurring in children and adolescents who have had contact with a cat, usually in the form of a scratch or bite. This manuscript will discuss the spectrum of radiologic manifestations of CSD emphasising key imaging findings of lymphadenopathy, hepatosplenic lesions, osteomyelitis, discitis, encephalitis, neuroretinitis and cranial neuritis.
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Affiliation(s)
- Aaron Rohr
- University of Kansas School of Medicine, 3550 Rainbow Blvd., Kansas City, KS 66103, USA.
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Emergent opportunities in humans: playful kittens, an arthropod vector, and a zoonotic agent. ASIAN BIOMED 2010. [DOI: 10.2478/abm-2010-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AbstractBartonella henselae is implicated as the main etiologic agent of Cat scratch disease (CSD, Cat-scratch fever). A majority of domestic cats may harbor the intra-erythrocytic agent for extended periods without apparent disease. In humans, B. henselae most commonly results in a subacute, bacterial infection that presents with one or more reddish papules which may progress to pustules and regional lymph node enlargement. Usual features include fever, malaise, and a granulomatous lymphadenitis on biopsy. However, atypical clinical presentations occur, albeit with infrequence, and may result in a difficult and protracted diagnostic process. The infection in susceptible hosts such as immunocompromised or elderly patients may result in endocarditis, encephalitis, fever of unknown origin, and general malaise. It is not transmitted from person to person and quarantine is not necessary. The arthropod vector, Ctenocephalides felis, or the cat flea, plays a major role in transmission among cats and to humans. The transmission risk to humans can be substantially reduced through elimination of flea infestations in companion animals. There are numerous recent reviews and case reports in the veterinary and medical literature reflecting increased recognition of this zoonotic agent. All this notwithstanding, many physicians and other providers may not be familiar with this agent and the potential spectrum of human disease; this may lead to delays in diagnosis and unnecessary diagnostic procedures. This article emphasizes the aspects of B. henselae infection, including a typical case report and a table with selected human case reports of unusual clinical manifestations from the published literature.
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Imaging Spectrum of Bites, Stings, and Their Complications:Pictorial Review. AJR Am J Roentgenol 2009; 193:S31-41, Quiz S42-5. [DOI: 10.2214/ajr.07.7123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Roubaud-Baudron C, Fortineau N, Goujard C, Le Bras P, Lambotte O. Maladie des griffes du chat avec localisations osseuses : une observation et revue de la littérature. Rev Med Interne 2009; 30:602-8. [DOI: 10.1016/j.revmed.2009.01.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Revised: 01/03/2009] [Accepted: 01/31/2009] [Indexed: 11/28/2022]
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