title: Multifocal osteomyelitis in a child: a rare manifestation of cat scratch disease: a case report and systematic review of the literature.
abstract: We present a case of a 9-year-old immunocompetent girl who presented with pain in her left elbow and a painful swelling at her left clavicle. She had no lymphadenopathy or fever. Four hot spots were seen at her left clavicle, proximal and distal left humerus and lumbo-sacral spine on a bone scan. A magnetic resonance imaging showed an inflammatory process with bone destruction at her clavicle. Serological testing and polymerase chain reaction performed on a bone biopsy identified a Bartonella henselae infection. She was treated with rifampin and trimethoprim-sulphamethoxazole. After a relapse half a year later, the patient recovered fully. Multifocal osteomyelitis is a rare manifestation of cat scratch disease in children.
authors.affiliation: Department of Orthopaedic Surgery, University Hospital Maastricht, Maastricht, The Netherlands.
authors.forename: Joris G J L
authors.initials: JG
authors.lastname: de Kort
authors.forename: Simon G F
authors.initials: SG
authors.lastname: Robben
authors.forename: Jaap J P
authors.initials: JJ
authors.lastname: Schrander
authors.forename: Lodewijk W
authors.initials: LW
authors.lastname: van Rhijn
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001473:Bartonella / Q000302:isolation & purification; D001842:Bone and Bones / Q000382:microbiology / Q000473:pathology; D002372:Cat-Scratch Disease / Q000150:complications* / Q000188:drug therapy; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010019:Osteomyelitis / Q000209:etiology* / Q000473:pathology; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents