Osteomyelitis in Cat Scratch Disease

Mechanism of spread: lymphatic or hematogenous

Clinical features:

(1) bone pain

(2) fever

(3) variable lymphadenopathy

(4) osteolysis at sites of infection

(5) evidence of Bartonella (positive seroconversion, identification of Bartonella henselae in PCR of lymph node, immunochemical, other)

The osteomyelitis may involve the

(1) base of the skull

(2) vertebral bodies

(3) pelvis

Multifocal disease may be present.

The osteomyelitis may be chronic.

The osteomyelitis typically improves after appropriate antibiotic therapy.