Journal Article

Cat-Scratch Disease with Paravertebral Mass and Osteomyelitis

Jenny M. B. Robson, Glenn J. Harte, Dennis R. S. Osborne and Joseph G. McCormack

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 28, issue 2, pages 274-278
Published in print February 1999 | ISSN: 1058-4838
Published online February 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515102
Cat-Scratch Disease with Paravertebral Mass and Osteomyelitis

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The case of a 9-year-old girl with cat-scratch disease (CSD) complicated by development of a paravertebral mass and osteomyelitis is presented. Following multiple scratches and inguinal lymphadenopathy, she developed back pain, and imaging demonstrated a paravertebral mass with evidence of osteomyelitis involving vertebra T9. The diagnosis was made on the basis of detection of Bartonella henselae by use of molecular techniques on an aspirate from the vertebral column and supportive serology for infection with B. henselae. Eleven other cases of this unusual manifestation associated with CSD have been reported in the literature and are reviewed. The patient was treated with gentamicin, followed by rifampicin and trimethoprim-sulfamethoxazole, orally and made a favorable recovery over 7 months. This is comparable with other case reports, regardless of the choice of antibiotic therapy. CSD in immunocompetent hosts is not always self-limiting, and tissues beyond the lymph nodes can be involved.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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