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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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2
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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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3
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Hepatosplenic Abscesses and Osteomyelitis of the Spine in an Immunocompetent Adult with Cat Scratch Disease. Case Rep Infect Dis 2015; 2015:317260. [PMID: 26576306 PMCID: PMC4631868 DOI: 10.1155/2015/317260] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Revised: 09/30/2015] [Accepted: 10/08/2015] [Indexed: 11/18/2022] Open
Abstract
We present an 18-year-old, immunocompetent Austrian military conscript with cervical lymphadenopathy, fever, back-pain, and persistent inflammation markers despite two weeks of antimicrobial therapy with ampicillin/sulbactam. All specific laboratory investigations for identification of a specific etiology, including blood cultures and autoantibodies, were inconspicuous. Abdominal computed tomography showed multiple hypodense hepatosplenic lesions and osteomyelitis of the thoracic and lumbar spine with base plate fracture. Based on the patient's history, clinical presentation, and radiological findings, serology for cat scratch disease (CSD) was performed and high B. henselae specific IgM and IgG antibodies were detected. Due to its variety of clinical presentations, diagnosis of CSD is challenging, especially in the absence of a history of specific exposure. This case report shall remind the physician that cat scratch disease is a common disease, mainly presenting with fever and lymphadenopathy in young patients. Nevertheless CSD has many different and rare forms of presentations, including hepatosplenic lesions and bone involvement as shown in this case.
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4
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Bieraugel K, Oehler D, NeSmith M, Chiovaro J. Cat got your spleen? Hepatosplenic Bartonella infection. Am J Med 2015; 128:246-9. [PMID: 25460524 DOI: 10.1016/j.amjmed.2014.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 11/10/2014] [Accepted: 11/10/2014] [Indexed: 11/17/2022]
Affiliation(s)
- Karen Bieraugel
- Department of Medicine, Oregon Health and Science University, Portland, OR
| | - Drew Oehler
- Department of Medicine, Oregon Health and Science University, Portland, OR
| | - Meghan NeSmith
- Department of Medicine, Oregon Health and Science University, Portland, OR
| | - Joseph Chiovaro
- Department of Medicine, Oregon Health and Science University, Portland, OR; Department of Medicine, Portland Veterans Affairs Medical Center, Portland, OR.
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5
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Jiyipong T, Jittapalapong S, Morand S, Rolain JM. Bartonella species in small mammals and their potential vectors in Asia. Asian Pac J Trop Biomed 2014. [DOI: 10.12980/apjtb.4.2014c742] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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6
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García JC, Núñez MJ, Castro B, Fernández JM, Portillo A, Oteo JA. Hepatosplenic cat scratch disease in immunocompetent adults: report of 3 cases and review of the literature. Medicine (Baltimore) 2014; 93:267-279. [PMID: 25398062 PMCID: PMC4602414 DOI: 10.1097/md.0000000000000089] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Cat-scratch disease (CSD) is the most frequent presentation of Bartonella henselae infection. It has a worldwide distribution and is associated with a previous history of scratch or bite from a cat or dog. CSD affects children and teenagers more often (80%) than adults, and it usually has a self-limiting clinical course. Atypical clinical course or systemic symptoms are described in 5%-20% of patients. Among them, hepatosplenic (HS) forms (abscess) have been described. The majority of published cases have affected children or immunosuppressed patients. Few cases of HS forms of CSD in immunocompetent adult hosts have been reported, and data about the management of this condition are scarce. Herein, we present 3 new cases of HS forms of CSD in immunocompetent adults and review 33 other cases retrieved from the literature. We propose an approach to clinical diagnosis and treatment with oral azithromycin.
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Affiliation(s)
- Juan C García
- Servicio de Medicina Interna (JCG, MJN), Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Galicia; Servicio de Medicina Interna (BC, JMF), Hospital Comarcal del Salnés, Vilagarcía de Arousa, Pontevedra, Galicia; Servicio de Medicina Interna (AL), Complejo Hospitalario Universitario de Ourense, Ourense, Galicia; Departamento de Enfermedades Infecciosas (AP, JAO), Hospital San Pedro-CIBIR, Logroño, La Rioja, Spain
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Maalouly C, Cecere N, Wilmes D, Demoulin N, Morelle J. Fever and lymphadenitis in an immunocompromised patient. Acta Clin Belg 2014; 69:214-6. [PMID: 24820922 DOI: 10.1179/2295333714y.0000000005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE AND IMPORTANCE Bartonella henselae infections are among the most common causes of fever and lymphadenopathies, but can lead to severe complications in immunocompromised hosts; early recognition of these infections is of paramount importance in immunocompromised patients. CLINICAL PRESENTATION Here we report the case of a renal transplant recipient who presented with fever, lymphadenopathies, and a splenic abscess secondary to Bartonella henselae infection, successfully treated with doxycycline. DISCUSSION AND CONCLUSIONS We discuss the various clinical presentations of Bartonella henselae infections in immunocompromised patients and the available diagnostic tools for this potentially severe complication.
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8
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Shasha D, Gilon D, Vernea F, Moses AE, Strahilevitz J. Visceral cat scratch disease with endocarditis in an immunocompetent adult: a case report and review of the literature. Vector Borne Zoonotic Dis 2014; 14:175-81. [PMID: 24575798 DOI: 10.1089/vbz.2012.1279] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Infective endocarditis and hepatosplenic abscesses are rare manifestations of cat scratch disease (CSD), especially among immunocompetent adults. An otherwise healthy woman who presented with fever and abdominal pain was diagnosed with multiple abscesses in the spleen and the liver, as well as a mitral valve vegetation. PCR on spleen tissue was positive for Bartonella henselae. Prolonged treatment with doxycycline and gentamicin led to complete recovery. Review of the literature revealed 18 cases of hepatosplenic CSD in immunocompetent adults; the majority presented with fever of unknown origin and abdominal pain. In most cases the causative organism was B. henselae and the pathological findings were necrotizing granulomas, similar to the pathological features in classic CSD. Concomitant endocarditis was diagnosed in one case. Because Bartonella is one of the leading pathogens of culture-negative endocarditis, we raise the question of whether a comprehensive evaluation for endocarditis is needed in cases of systemic CSD.
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Affiliation(s)
- David Shasha
- 1 The Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center , Jerusalem, Israel
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9
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Grossi O, Denoyel GA, Redon H, Caignon JM, Généreau T, de Faucal P. Challenges in the diagnosis of culture negative vertebral osteomyelitis in adults: Case of Bartonella henselae infection. Joint Bone Spine 2013; 80:671-3. [DOI: 10.1016/j.jbspin.2013.02.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 02/28/2013] [Indexed: 10/26/2022]
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10
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Beyond cat scratch disease: a case report of bartonella infection mimicking vasculitic disorder. Case Rep Infect Dis 2012; 2012:354625. [PMID: 22924138 PMCID: PMC3423660 DOI: 10.1155/2012/354625] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 07/18/2012] [Indexed: 11/17/2022] Open
Abstract
Cat scratch disease (CSD) is a bacterial disease caused by Bartonella henselae and it is mainly characterized by self-limiting lymphadenopathy in the draining site of a cat scratch or bite. We report a patient with history of fever, swelling lymph nodes, vasculitic-like skin lesions, and positivity of Bartonella serology initially considered as expression of a disimmune disease.
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11
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Graveleau J, Grossi O, Lefebvre M, Redon H, Caignon JM, Pallardy A, Bodet-Milin C, Néel A, Hamidou MA. Vertebral osteomyelitis: an unusual presentation of Bartonella henselae infection. Semin Arthritis Rheum 2011; 41:511-6. [PMID: 21840042 DOI: 10.1016/j.semarthrit.2011.04.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2011] [Revised: 04/24/2011] [Accepted: 04/26/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To report cases of cat scratch disease with vertebral osteomyelitis. METHODS We describe clinical features, diagnostic, treatment, and outcome of 2 patients with vertebral osteomyelitis due to Bartonella henselae and provide a review of the relevant literature. RESULTS A 47-year-old man was investigated for fever, splenomegaly, and cervical adenopathy. A lymphoma was suspected on the clinical picture, the laboratory tests, and the computed tomographic scan. [(18)F]-fluoro-2-deoxy-d-glucose-positron emission tomography detected splenic nodules and a hypermetabolic focus of C7 vertebral body compatible with a vertebral osteomyelitis on magnetic resonance imaging. B henselae infection was confirmed by polymerase chain reaction performed on lymph node biopsy. A 34-year-old woman was investigated for fever and right upper quadrant abdominal pain. She had consulted 2 weeks before for a unique lesion of right index and an axillar adenopathy that have improved spontaneously. A technetium bone scan performed 1 week later because of a thoracic backache demonstrated an increased uptake of the T6 vertebra. Vertebral magnetic resonance imaging was compatible with a T6 osteomyelitis. B henselae infection was confirmed by serology (seroconversion). Both patients were treated with rifampin and doxycycline and recovered within 3 months. CONCLUSIONS B henselae vertebral osteomyelitis can involve immunocompetent adults. In the case of vertebral osteomyelitis with negative blood cultures, recent history of local lymphadenopathy and cat exposure must be investigated and B henselae serology must be performed. Nevertheless, even if serology is positive, vertebral biopsy is required to rule out other pathogens or malignancy. B henselae infection can be confirmed by polymerase chain reaction performed on vertebral or lymph node biopsy.
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Affiliation(s)
- Julie Graveleau
- Service de Médecine Interne, Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France
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12
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Piérard-Franchimont C, Quatresooz P, Piérard GE. Skin diseases associated with Bartonella infection: facts and controversies. Clin Dermatol 2010; 28:483-8. [PMID: 20797506 DOI: 10.1016/j.clindermatol.2010.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The genus Bartonella is composed of a series of species and subspecies. Ten of them are responsible for human infections. The best-identified diseases are cat scratch disease (B henselae and possibly B clarridgeiae), trench fever (B quintana), bacillary angiomatosis (B quintana and B henselae), and the spectrum of verruga peruana, Carrion disease, and Oroya fever (B bacilliformis). Controversies exist about the implication of a few other microorganisms being involved in these diseases. Several other conditions have been associated with the presence of Bartonella spp, but these observations await confirmation.
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13
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Lin JW, Chen CM, Chang CC. Unknown fever and back pain caused by Bartonella henselae in a veterinarian after a needle puncture: a case report and literature review. Vector Borne Zoonotic Dis 2010; 11:589-91. [PMID: 20569013 DOI: 10.1089/vbz.2009.0217] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Bartonella henselae, the etiologic agent of cat-scratch disease, rarely causes back pain and is considered to be transmitted through animal scratches and bites. Here we report a cat-scratch disease case possibly with an unusual route of transmission. The patient was a 32-year-old man, and he was working as a veterinarian in a private veterinary clinic. He sought for clinical help because of unknown fever and persistent back pain for at least a month after an accidental needle puncture. Through serological testing and molecular identifications, this clinical case was confirmed to be caused by B. henselae.
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Affiliation(s)
- Jen-Wei Lin
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan
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14
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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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15
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Usefulness of broad-range PCR for the diagnosis of osteoarticular infections. Curr Opin Rheumatol 2008; 20:463-70. [PMID: 18525362 DOI: 10.1097/bor.0b013e3283032030] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Conventional methods such as microbiological cultures may lack the sensitivity and specificity to establish definitive diagnosis of osteoarticular infections. Herein, we review the general principles and the usefulness of broad-range PCR to improve the etiological diagnosis of osteoarticular infections. RECENT FINDINGS Broad-range PCR followed by sequencing has been successfully developed to identify microorganisms involved in infections when patients have previously received antibiotics or in the presence of slow-growing or intracellular microorganisms. For osteoarticular infections, the studies have shown that the use of this molecular tool increased mainly the identification of Kingella kingae, anaerobic bacteria, and Streptococcus spp. However, it is very important to underline that the interpretation of this molecular tool is critical because of several pitfalls, including contamination causing false-positive results. SUMMARY Broad-range PCR followed by sequencing offers several advantages when used to complement culture results for the diagnosis of fastidious bacteria and for patients taking antibiotics. However, its use should be restricted mainly for culture-negative cases when infection is suspected on the basis of clinical signs and symptoms or inflammatory syndrome. Future developments will include the use of real-time PCR in a closed system and pathogen-specific PCR for the molecular diagnosis of osteoarticular infections.
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16
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Florin TA, Zaoutis TE, Zaoutis LB. Beyond cat scratch disease: widening spectrum of Bartonella henselae infection. Pediatrics 2008; 121:e1413-25. [PMID: 18443019 DOI: 10.1542/peds.2007-1897] [Citation(s) in RCA: 205] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Bartonella henselae was discovered a quarter of a century ago as the causative agent of cat scratch disease, a clinical entity described in the literature for more than half a century. As diagnostic techniques improve, our knowledge of the spectrum of clinical disease resulting from infection with Bartonella is expanding. This review summarizes current knowledge regarding the microbiology, clinical manifestations, diagnostic techniques, and treatment of B. henselae infection.
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Affiliation(s)
- Todd A Florin
- Division of General Pediatrics, Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA.
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17
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Fisher W. Images in Emergency Medicine. Ann Emerg Med 2007; 50:90, 97. [PMID: 17572294 DOI: 10.1016/j.annemergmed.2006.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2006] [Revised: 11/28/2006] [Accepted: 12/12/2006] [Indexed: 11/18/2022]
Affiliation(s)
- Whit Fisher
- Bellevue Hospital Center, Emergency Medicine Department, New York, NY, USA
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18
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Hajjaji N, Hocqueloux L, Kerdraon R, Bret L. Bone infection in cat-scratch disease: A review of the literature. J Infect 2007; 54:417-21. [PMID: 17140668 DOI: 10.1016/j.jinf.2006.10.045] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2006] [Accepted: 10/16/2006] [Indexed: 11/28/2022]
Abstract
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 9 years, 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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Affiliation(s)
- Nawale Hajjaji
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Régional-La Source, BP 86709, 45067 Orléans Cedex 2, France
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19
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Keynan Y, Yakirevitch E, Shusterman T, Alter-Migdal E, Avidor B, Weber G, Giladi M. Bone marrow and skin granulomatosis in a patient with Bartonella infection. J Med Microbiol 2007; 56:133-135. [PMID: 17172528 DOI: 10.1099/jmm.0.46649-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This report describes a case of granulomatous inflammation, involving the bone marrow and skin, due to Bartonella infection in an immunocompetent patient. The clinical presentation included prolonged fever, pancytopenia, rash and hepatitis. Bartonella infection should thus be added to the growing list of entities that produce marrow granulomas and fever.
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Affiliation(s)
- Yoav Keynan
- Department of Internal Medicine, Infectious Disease Unit, Carmel Hospital, Haifa, Israel
| | | | | | - Erella Alter-Migdal
- Department of Internal Medicine, Infectious Disease Unit, Carmel Hospital, Haifa, Israel
| | - Boaz Avidor
- Bernard Pridan Laboratory for Molecular Biology of Infectious Diseases, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Gabriel Weber
- Department of Internal Medicine, Infectious Disease Unit, Carmel Hospital, Haifa, Israel
| | - Michael Giladi
- Bernard Pridan Laboratory for Molecular Biology of Infectious Diseases, Tel Aviv Medical Center, Tel Aviv, Israel
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20
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Rolain JM, Lepidi H, Zanaret M, Triglia JM, Michel G, Thomas PA, Texereau M, Stein A, Romaru A, Eb F, Raoult D. Lymph node biopsy specimens and diagnosis of cat-scratch disease. Emerg Infect Dis 2006; 12:1338-44. [PMID: 17073081 PMCID: PMC3294744 DOI: 10.3201/eid1209.060122] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Histologic analysis of lymph node biopsy specimens may verify diagnosis of this disease. We report microbiologic analysis of 786 lymph node biopsy specimens from patients with suspected cat-scratch disease (CSD). The specimens were examined by standard, cell culture, and molecular methods. Infectious agents were found in samples from 391 (49.7%) of 786 patients. The most commonly identified infectious agent was Bartonella henselae (245 patients, 31.2%), the agent of CSD. Mycobacteriosis was diagnosed in 54 patients (6.9%) by culture and retrospectively confirmed by using a specific real-time PCR assay. Neoplasm was diagnosed in 181 specimens suitable for histologic analysis (26.0%) from 47 patients. Moreover, 13 patients with confirmed Bartonella infections had concurrent mycobacteriosis (10 cases) or neoplasm (3 cases). A diagnosis of CSD does not eliminate a diagnosis of mycobacteriosis or neoplasm. Histologic analysis of lymph node biopsy specimens should be routinely performed because some patients might have a concurrent malignant disease or mycobacteriosis.
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Affiliation(s)
| | | | | | | | | | | | | | - Andreas Stein
- Université de la Méditerranée, Marseille, France
- Hôpital de la Conception, Marseille, France
| | | | - François Eb
- Centre Hospitalier Universitaire, Amiens, France
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21
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Vermeulen MJ, Rutten GJ, Verhagen I, Peeters MF, van Dijken PJ. Transient paresis associated with cat-scratch disease: case report and literature review of vertebral osteomyelitis caused by Bartonella henselae. Pediatr Infect Dis J 2006; 25:1177-81. [PMID: 17133166 DOI: 10.1097/01.inf.0000246807.14916.d3] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
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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Affiliation(s)
- Marijn J Vermeulen
- Department of Pediatrics, St. Elisabeth Hospital, Tilburg, The Netherlands.
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22
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Jeong W, Seiter K, Strauchen J, Rafael T, Lau HC, Breakstone B, Ahmed T, Liu D. PET scan-positive cat scratch disease in a patient with T cell lymphoblastic lymphoma. Leuk Res 2005; 29:591-4. [PMID: 15755513 DOI: 10.1016/j.leukres.2004.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2004] [Accepted: 12/23/2004] [Indexed: 10/25/2022]
Abstract
In patients who have history of lymphoma, a positive positron emission tomography (PET) scan is frequently considered as good evidence for relapse and/or persistent disease. Thus, lymph node biopsy is not always done to confirm the diagnosis of relapse or refractory lymphoma before a patient is subjected to further chemotherapy. We report a case of patient with history of T cell lymphoblastic lymphoma who presented again with inguinal lymphadenopathy and positive study on positron emission tomography suggestive of lymphoma relapse. This was pathologically proven to be cat scratch disease. This case suggests that in the immunocompromised patients who had history of lymphoma, infectious etiology should be ruled out for PET scan-positive lymphadenopathy.
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Affiliation(s)
- Woondong Jeong
- Arlin Cancer Institute and New York Medical College, Valhalla, NY 10595, USA
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23
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Manfredi R, Sabbatani S, Chiodo F. Bartonellosis: light and shadows in diagnostic and therapeutic issues. Clin Microbiol Infect 2005; 11:167-9. [PMID: 15715712 DOI: 10.1111/j.1469-0691.2004.01010.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Cat-scratch disease involves a prolonged and/or complicated course, and lymph node drainage is usually required. Culture and molecular techniques often yield negative results, but immunofluorescence assays may give early information, and elevated antibodies may persist for months. Cat-scratch disease should be suspected in patients with prominent swelling of lymph nodes draining from the upper limbs, limited systemic involvement, and typical epidemiological-clinical features. The temporal antibody response during the sub-acute course remains unknown. Although biomolecular assays are available, the time between onset and investigation is an obstacle to positive results. The role of surgical debridement and the unpredictable activity of antimicrobial agents warrant further investigation.
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24
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Rodrick D, Dillon B, Dexter M, Nicholson I, Marcel S, Dickeson D, Iredell J. Culture-negative endocarditis due to Houston Complex Bartonella henselae acquired in Noumea, New Caledonia. J Clin Microbiol 2004; 42:1846-8. [PMID: 15071067 PMCID: PMC387567 DOI: 10.1128/jcm.42.4.1846-1848.2004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
A 44-year-old man with a bioprosthetic aortic valve suffered destructive endocarditis with severe embolic disease due to Bartonella henselae infection. Multilocus sequence typing was successfully performed with crude preparations of operative tissue as templates, and the infecting organism was determined to be typical of the Houston clonal group, although it was never cultured from blood or tissue. This is the first report of B. henselae infection in the South Pacific, and it reminds one that B. henselae is a cause of potentially lethal culture-negative endocarditis which may respond poorly to conventional empirical therapy. Nothing is known of the epidemiology of the infection in this region, but it is likely to be common and to contain representatives of both major clonal complexes. This study emphasizes the ease with which multilocus sequence typing can be used directly with tissue, which is important because of suggestions of strain-dependent clinical outcomes.
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Affiliation(s)
- Dani Rodrick
- Westmead Private Hospital, Sydney, New South Wales, Australia
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25
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Rolain JM, Gouriet F, Enea M, Aboud M, Raoult D. Detection by immunofluorescence assay of Bartonella henselae in lymph nodes from patients with cat scratch disease. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2003; 10:686-91. [PMID: 12853405 PMCID: PMC164252 DOI: 10.1128/cdli.10.4.686-691.2003] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Laboratory diagnosis of Bartonella henselae infections can be accomplished by serology or PCR assay on biopsy samples. The purpose of our work was to assess immunofluorescence detection (IFD) in lymph node smears using a specific monoclonal antibody directed against B. henselae and a commercial serology assay (IFA) compared with PCR detection. Among 200 lymph nodes examined from immunocompetent patients, 54 were positive for B. henselae by PCR, of which 43 were also positive by IFD. Among the 146 PCR-negative lymph nodes, 11 were positive by IFD. Based on PCR results, the specificity of this new technique was 92.5%, the sensitivity was 79.6%, and the positive predictive value was 79.6%. At a cutoff titer of 64, the sensitivity of the IFA was 86.8% and the specificity was 74.1%. Diagnosis of cat scratch disease (CSD) may be improved, with a specificity of 100%, when the two tests (IFD and IFA) were negative; the sensitivity was 97.4% if one of the two tests was positive. Since PCR-based detection with biopsy samples is available only in reference laboratories, we suggest using IFD coupled with the commercial serology test for the diagnosis of CSD.
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Affiliation(s)
- J M Rolain
- Unité des Rickettsies, CNRS UMR 6020A, Faculté de Médecine, Université de la Méditerranée, 13385 Marseille Cedex 05, France
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