Cat-scratch disease presenting as multifocal osteomyelitis with thoracic abscess

The case of a 4-year-old girl who presented with fever and back pain after being scratched by a kitten is presented. The diagnosis of cat scratch disease osteomyelitis was made by the detection of Bartonella henselae DNA by PCR analysis of a rib abscess aspirate.     

Cat-scratch disease associated with an osteolytic lesion

Lytic bone involvement accompanying cat-scratch disease has been described previously in three patients. I observed a fourth patient with this pathologic condition and noted variations among the four patients. To my knowledge, this patient is the first in whom extension from an involved lymph node to a bone was direct.     

Cat-scratch disease with reversible encephalopathy

A case of cat-scratch disease (CSD) complicated by reversible encephalopathy is presented. Neurological complications of CSD are uncommon. Laboratory and radiological examinations were negative. There was complete recovery.     

Deep vein thrombosis associated with osteomyelitis

Three children developed deep vein thrombosis (DVT) along with osteomyelitis of the femur. Although DVT was recognized early, the diagnosis of associated osteomyelitis was delayed due to overlapping clinical signs and the absence of radiological changes in the initial X-rays.     

Cat-scratch disease occurring in three siblings simultaneously

We report for the first time three siblings with cat-scratch disease occurring simultaneously. Case 1 was an 8-year-old boy with enlarged supraclavicular lymph nodes and fever. Case 2 was the 11-year-old sister whose presentation was a prolonged febrile illness. Case 3 was a 13-year-old male adolescent with adenitis of the neck and thigh. All three patients were treated with rifampin with improvement of their symptoms.     

Cat-scratch disease relapse in a kidney transplant recipient

Cat-scratch disease, an infectious illness infrequently reported in kidney transplant patients, is caused by the organism Bartonella henselae and is transmitted through contact with cats or kittens. It is a self-limited disorder in the general pediatric population. Here we present a case of unsuspected cat-scratch disease in a pediatric kidney transplant patient who presented with fever and lymphadenopathy. Eight months after treatment with a short course of azithromycin, the patient developed a recurrence of cat-scratch disease. We emphasize that the evaluation of a young immunocompromised kidney transplant patient presenting with fever and lymphadenopathy should include unusual infections such as cat-scratch disease. We review the diagnosis and treatment of this uncommon infection in the organ transplant population.