Bartonella henselae infection presenting as cervical spine osteomyelitis: case report

Bartonella henselae is a gram-negative bacillus implicated in cat-scratch disease. Cat-scratch disease is usually self-limiting and results in local lymphadenopathy. In rare circumstances, patients may develop endocarditis, neuroretinitis, or osteomyelitis. Osteomyelitis of the cervical spine is exceedingly rare, especially in the pediatric population, and to date there have been only 4 previously reported cases of cervical spine osteomyelitis caused by B. henselae, all of which were treated surgically. In this article, the authors report the case of a 7-year-old boy who presented with neck swelling and was found to have a C2-4 paravertebral B. henselae abscess with osteomyelitis of C-3 and epidural extension. To the authors' knowledge, this represents the first case in the literature of a cervical spine B. henselae infection managed conservatively.