Bone infection in cat-scratch disease: A review of the literature

• Published in: The Journal of infection Vol. 54; no. 5; pp. 417 - 421
• Main Authors: Hajjaji, Nawale, Hocqueloux, Laurent, Kerdraon, Rémy, Bret, Laurent
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.05.2007; Elsevier
• Subjects: Adolescent; Adult; Animals; Bacterial diseases; Bartonella; Bartonella henselae; Bartonella henselae - isolation & purification; Bartonellosis; Biological and medical sciences; Bone infection; Cat-scratch disease; Cat-Scratch Disease - complications; Cat-Scratch Disease - microbiology; Cats; Child; Child, Preschool; Female; Human bacterial diseases; Humans; Infectious Disease; Infectious diseases; Male; Medical sciences; Osteomyelitis; Osteomyelitis - etiology; Osteomyelitis - pathology; Pelvis - microbiology; Pelvis - pathology; Review; Spine - microbiology; Spine - pathology; Tropical bacterial diseases; Osteomyelitis; Bartonella henselae; Bone infection; Review; Cat-scratch disease; Infection; Bacteriosis; Bone; Bibliographic review; Cat scratch disease
• ISSN: 0163-4453; 1532-2742; 1532-2742
• DOI: 10.1016/j.jinf.2006.10.045

To describe the main features of bone infection associated with Cat-scratch disease (CSD). We searched for articles indexed in the international literature databases by using the following key words: “ Bartonella”, “bone”, “cat-scratch”, “osteomyelitis” and “osteolytic”. Cases of 47 patients were reviewed. The median age was 9 years, with an equal sex distribution. Bone pain and fever were the main symptoms. The presence of fever and increased age were more common in patients with bone infection than classically reported in uncomplicated (i.e. nodal) CSD. The vertebral column and pelvic girdle were the most common sites of infection. Radiological examination typically confirmed bone osteolysis. All patients recovered without complications or chronic infection, although they received a various combination antibiotic regimen and duration therapy. The mechanism by which infection might spread to the bone is via the haematogenous route, accounting for most of the disseminated cases and via the lymphatic route, for those with regional limited extension. Bone infection is rare but should be considered when bone pain and fever are present in a patient with nodal CSD. The prognosis is good, whatever treatment is given. Thus bone biopsy should be recommended only in a difficult diagnostic setting, when other bacteria or malignant disease are suspected.