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Cat-scratch disease presenting as multifocal osteomyelitis with thoracic abscess
S P Modi1, S C Eppes, J D Klein
1Department of Pediatrics, Alfred I. duPont Hospital for Children, Wilmington, DE, USA.
The Pediatric Infectious Disease Journal
|October 20, 2001
Insights
A pediatric case of cat scratch disease osteomyelitis was diagnosed in a 4-year-old girl presenting with fever and back pain. Bartonella henselae DNA was detected in rib abscess aspirate via PCR analysis, confirming the diagnosis.
Area of Science:
- Infectious Diseases
- Pediatric Osteomyelitis
- Bacteriology
Background:
- Cat scratch disease (CSD) is a bacterial infection typically caused by Bartonella henselae.
- While CSD commonly presents with lymphadenopathy, atypical presentations can occur, particularly in pediatric patients.
- Osteomyelitis, a bone infection, is a rare but serious complication of CSD.
Observation:
- A 4-year-old girl presented with symptoms of fever and back pain.
- The patient had a history of a recent scratch from a kitten.
- Physical examination revealed a rib abscess.
Findings:
- Diagnosis of CSD osteomyelitis was established through laboratory analysis.
- Polymerase chain reaction (PCR) analysis of the rib abscess aspirate detected Bartonella henselae DNA.
- This molecular detection confirmed the causative agent of the osteomyelitis.
Implications:
- This case highlights the importance of considering CSD in pediatric patients with unexplained fever and bone pain, especially after animal contact.
- Early diagnosis and appropriate treatment of CSD osteomyelitis are crucial to prevent long-term complications.
- PCR detection of Bartonella henselae DNA is a valuable tool for diagnosing atypical CSD presentations.
Abstract:
The case of a 4-year-old girl who presented with fever and back pain after being scratched by a kitten is presented. The diagnosis of cat scratch disease osteomyelitis was made by the detection of Bartonella henselae DNA by PCR analysis of a rib abscess aspirate.