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Osteomyelitis in Cat-Scratch Disease: A Never-Ending Dilemma—A Case Report and Literature Review
Joint Authors
Donà, D.
Mozzo, E.
Nai Fovino, L.
Cabrelle, G.
Bordin, G.
Lundin, R.
Giaquinto, C.
Zangardi, T.
Rampon, O.
Source
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-8, 8 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-04-01
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Abstract EN
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.
American Psychological Association (APA)
Donà, D.& Nai Fovino, L.& Mozzo, E.& Cabrelle, G.& Bordin, G.& Lundin, R.…[et al.]. 2018. Osteomyelitis in Cat-Scratch Disease: A Never-Ending Dilemma—A Case Report and Literature Review. Case Reports in Pediatrics،Vol. 2018, no. 2018, pp.1-8.
https://search.emarefa.net/detail/BIM-1149011
Modern Language Association (MLA)
Donà, D.…[et al.]. Osteomyelitis in Cat-Scratch Disease: A Never-Ending Dilemma—A Case Report and Literature Review. Case Reports in Pediatrics No. 2018 (2018), pp.1-8.
https://search.emarefa.net/detail/BIM-1149011
American Medical Association (AMA)
Donà, D.& Nai Fovino, L.& Mozzo, E.& Cabrelle, G.& Bordin, G.& Lundin, R.…[et al.]. Osteomyelitis in Cat-Scratch Disease: A Never-Ending Dilemma—A Case Report and Literature Review. Case Reports in Pediatrics. 2018. Vol. 2018, no. 2018, pp.1-8.
https://search.emarefa.net/detail/BIM-1149011
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1149011