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Cat-scratch disease with paravertebral mass and osteomyelitis
J M Robson1, G J Harte, D R Osborne
1Sullivan Nicolaides Pathology, Taringa, Australia.
Summary
Cat-scratch disease (CSD) can cause rare bone infections like vertebral osteomyelitis in children. Early diagnosis using molecular techniques and appropriate antibiotics leads to favorable recovery.
Area of Science:
- Infectious Diseases
- Pediatric Osteomyelitis
- Bartonella henselae Infections
Background:
- Cat-scratch disease (CSD) is typically a self-limiting illness caused by Bartonella henselae.
- Uncommon complications can extend beyond lymphadenopathy, affecting other organ systems.
Observation:
- A 9-year-old girl presented with back pain, a paravertebral mass, and osteomyelitis of vertebra T9.
- Imaging confirmed the paravertebral mass and vertebral involvement.
Findings:
- Diagnosis of Bartonella henselae infection was confirmed via molecular detection in vertebral aspirate and serology.
- Review of literature identified 11 similar cases of CSD-associated vertebral osteomyelitis.
Implications:
- CSD can manifest with severe skeletal complications, even in immunocompetent children.
- Prompt diagnosis and multi-drug antibiotic therapy are crucial for favorable outcomes in complicated CSD cases.
- This case highlights the importance of considering CSD in pediatric patients with unexplained osteomyelitis.
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