Bartonella henselae Hepatic Abscesses and Associated Osteomyelitis in a Pediatric Patient

is a Gram-negative bacillus transmitted to humans via cat saliva or scratch. Cat scratch disease, the typical clinical manifestation of infection, presents as localized cutaneous or regional lymphadenopathy. Rare, atypical presentations, generally reflecting bloodborne disseminated disease, can incl...

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Bibliographic Details
Published in:Case reports in infectious diseases 2024, Vol.2024 (1), p.7810497
Main Authors: Antonson, Molly, Klingemann, Lauren, Neemann, Kari
Format: Article
Language:English
Subjects:
Abscess
Abscesses
Antimicrobial agents
Blood
Case Report
Children
Deoxyribonucleic acid
Disease transmission
DNA
Fever
Health aspects
Immunocompetence
Immunoglobulins
Infections
Infectious diseases
Magnetic resonance imaging
Osteomyelitis
Pathogens
Patients
Pediatrics
Penicillin G benzathine
Polymerase chain reaction
Ribonucleic acid
Rifampin
RNA
Serology
Social history
Tetracycline
Tetracyclines
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Description
Summary:is a Gram-negative bacillus transmitted to humans via cat saliva or scratch. Cat scratch disease, the typical clinical manifestation of infection, presents as localized cutaneous or regional lymphadenopathy. Rare, atypical presentations, generally reflecting bloodborne disseminated disease, can include hepatosplenic, cardiac, ocular, neurologic, or musculoskeletal involvement. Here, we present a case of disseminated with hepatic abscesses and associated ischial osteomyelitis in an immunocompetent 2-year-old male patient. Although osteomyelitis is a rare manifestation of infection, it should be included in the differential diagnosis in pediatric patients presenting with fever of unknown origin and musculoskeletal pain, especially in the setting of cat exposure. Hepatic involvement of infection is associated with significant morbidity; therefore, abdominal imaging is critical in the diagnostic workup. This patient was successfully treated after a 6-week course of azithromycin and rifampin, as evidenced by symptom resolution and improved fluid collections on repeat imaging. While most cases of resolve without treatment, in severe or disseminated infection such as this case, antibiotics such as azithromycin and rifampin should be considered for treatment.
ISSN:2090-6625
2090-6633
DOI:10.1155/2024/7810497