Showing Latest Articles
Vertebral Osteomyelitis: An Unusual Presentation of Bartonella henselae Infection
Seminars in Arthritis and Rheumatism, 08/17/2011
Graveleau J et al. – B henselae vertebral osteomyelitis can involve immunocompetent adults. In the case of vertebral osteomyelitis with negative blood cultures, recent history of local lymphadenopathy and cat exposure must be investigated and B henselae serology must be performed. Nevertheless, even if serology is positive, vertebral biopsy is required to rule out other pathogens or malignancy. B henselae infection can be confirmed by polymerase chain reaction performed on vertebral or lymph node biopsy.
Methods- The authors describe clinical features, diagnostic, treatment, and outcome of 2 patients with vertebral osteomyelitis due to Bartonella henselae and provide a review of the relevant literature.
- A 47–year–old man was investigated for fever, splenomegaly, and cervical adenopathy.
- A lymphoma was suspected on the clinical picture, the laboratory tests, and the computed tomographic scan.
- [18F]–fluoro–2–deoxy–d–glucose–positron emission tomography detected splenic nodules and a hypermetabolic focus of C7 vertebral body compatible with a vertebral osteomyelitis on magnetic resonance imaging.
- B henselae infection was confirmed by polymerase chain reaction performed on lymph node biopsy.
- A 34–year–old woman was investigated for fever and right upper quadrant abdominal pain.
- She had consulted 2 weeks before for a unique lesion of right index and an axillar adenopathy that have improved spontaneously.
- A technetium bone scan performed 1 week later because of a thoracic backache demonstrated an increased uptake of the T6 vertebra.
- Vertebral magnetic resonance imaging was compatible with a T6 osteomyelitis.
- B henselae infection was confirmed by serology (seroconversion).
- Both patients were treated with rifampin and doxycycline and recovered within 3 months.
