J Med Microbiol Track the topics, authors and articles important to you
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ridder-Schröter, R.
Right arrow Articles by Girschick, H. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ridder-Schröter, R.
Right arrow Articles by Girschick, H. J.
Agricola
Right arrow Articles by Ridder-Schröter, R.
Right arrow Articles by Girschick, H. J.
J Med Microbiol 57 (2008), 519-524; DOI: 10.1099/jmm.0.47438-0
© 2008 Society for General Microbiology
ISSN 1473-5644

Case Report

Abscess-forming lymphadenopathy and osteomyelitis in children with Bartonella henselae infection

Regina Ridder-Schröter1, Aleander Marx2, Meinrad Beer3, Dennis Tappe4, Hans-Wolfgang Kreth1 and Hermann J. Girschick1

1 Children's Hospital, University of Würzburg, 97080 Würzburg, Germany

2 Institute of Pathology, University of Würzburg, 97080 Würzburg, Germany

3 Department of Radiology, Section of Pediatric Radiology, University of Würzburg, 97080 Würzburg, Germany

4 Institute of Hygiene and Microbiology, University of Würzburg, 97080 Würzburg, Germany

Correspondence
Hermann J. Girschick
Hermann.Girschick{at}mail.uni-wuerzburg.de

Received 9 June 2007
Accepted 3 December 2007

Bartonella henselae is the agent of cat-scratch disease (CSD), a chronic lymphadenopathy among children and adolescents. A systemic infection is very rare and most of these cases are found in patients with immunodeficiency. Here, cases involving four children of 6–12 years of age are reported. Three of the children had an abscess-forming lymphadenopathy and surrounding myositis in the clavicular region of the upper arm. The diagnosis was made serologically and, in one case, using eubacterial universal PCR. One child was treated with erythromycin for 10 days, the second received cefotaxime and flucloxacillin for 14 days and the third child was not treated with antibiotics. The fourth child had a different course: a significantly elevated signal intensity affecting the complete humerus was found in magnetic resonance imaging, consistent with osteomyelitis. A lymph node abscess was also found in the axilla. Diagnosis was established by indirect fluorescence assay and lymph node biopsy. Antibiotic therapy using clarithromycin, clindamycin and rifampicin was gradually successful. Immunodeficiency was excluded. All described lesions healed without residues. In immunocompetent patients, infection affects skin and draining lymph nodes; however, prolonged fever of unknown origin as in the fourth patient indicated a systemic complication of CSD.

Abbreviations: CSD, cat-scratch disease; ESR, erythrocyte sedimentation rate; IFA, indirect fluorescence assay; MRI, magnetic resonance imaging.




This article has been cited by other articles:


Home page
 Arch Pediatr Adolesc MedHome page
Picture of the Month--Diagnosis
Arch Pediatr Adolesc Med, January 1, 2009; 163(1): 86 - 86.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
INT J SYST EVOL MICROBIOL J MED MICROBIOL MICROBIOLOGY J GEN VIROL ALL SGM JOURNALS
Copyright © 2008 Society for General Microbiology.