{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T15:39:10Z","timestamp":1788881950734,"version":"build-2803163510"},"reference-count":18,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,5,2]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>Cat-scratch disease is a zoonosis caused by <jats:italic>Bartonella henselae<\/jats:italic>, characterised by regional lymphadenopathy. Rarer presentations, such as osteomyelitis, can occur.<\/jats:p>\n               <jats:p>We present an adolescent girl with severe right lumbar pain and fever, without animal contacts or recent travels. On examination, pain on flexion of torso, movement limitation and marked lordosis were noted, but there were no inflammatory signs, palpable masses or lymph nodes. Serological investigations revealed elevated inflammatory markers. Imaging revealed a paravertebral abscess with bone erosion. Several microbiological agents were ruled out. After a second CT-guided biopsy, PCR for <jats:italic>Bartonella spp<\/jats:italic> was positive. At this point, the family recalled having a young cat some time before. Cat-scratch disease was diagnosed, and complete recovery achieved after treatment with doxycycline and rifampicin.<\/jats:p>\n               <jats:p>Cat-scratch disease is a challenging diagnosis in the absence of typical features. However, <jats:italic>B. henselae<\/jats:italic> must be investigated if common pathogens are ruled out and response to therapy is poor.<\/jats:p>","DOI":"10.1136\/bcr-2023-257341","type":"journal-article","created":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T07:00:19Z","timestamp":1715324419000},"page":"e257341","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Cat-scratch disease: a rare cause of osteomyelitis"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6097-0012","authenticated-orcid":false,"given":"Ricardo","family":"Domingos Grilo","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Women and Child Department, Hospital do Espirito Santo de Evora EPE, \u00c9vora, Portugal"},{"name":"Pediatrics Infectious Diseases and Immunodeficiency Unit, Department of Pediatrics, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Madureira","sequence":"additional","affiliation":[{"name":"Radiology Department, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Reis Melo","sequence":"additional","affiliation":[{"name":"Pediatrics Infectious Diseases and Immunodeficiency Unit, Department of Pediatrics, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarida","family":"Tavares","sequence":"additional","affiliation":[{"name":"Pediatrics Infectious Diseases and Immunodeficiency Unit, Department of Pediatrics, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,5,10]]},"reference":[{"key":"2025082801273348000_17.5.e257341.1","article-title":"Osteomyelitis in cat-scratch disease: a never-ending dilemma \u2013 a case report and literature review","volume":"2018","author":"Don\u00e0","year":"2018","journal-title":"Case Rep Pediatr"},{"key":"2025082801273348000_17.5.e257341.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199307013290102"},{"key":"2025082801273348000_17.5.e257341.3","first-page":"152","article-title":"Cat-scratch disease","volume":"83","author":"Klotz","year":"2011","journal-title":"Am Fam Physician"},{"key":"2025082801273348000_17.5.e257341.4","doi-asserted-by":"publisher","DOI":"10.1086\/515102"},{"key":"2025082801273348000_17.5.e257341.5","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1089\/vbz.2014.1758","article-title":"Bartonella Osteomyelitis of the Acetabulum: case report and review of the 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Chemother"},{"key":"2025082801273348000_17.5.e257341.12","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-000-0026-8"},{"key":"2025082801273348000_17.5.e257341.13","doi-asserted-by":"crossref","DOI":"10.1002\/ccr3.6117","article-title":"Bartonella Henselae vertebral Osteomyelitis in a pediatric patient: a case report","volume":"10","author":"Abu-Rumeileh","year":"2022","journal-title":"Clin Case Rep"},{"key":"2025082801273348000_17.5.e257341.14","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-1897"},{"key":"2025082801273348000_17.5.e257341.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2006.10.045"},{"key":"2025082801273348000_17.5.e257341.16","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1080\/17453674.2021.1941624","article-title":"Cat at home? cat scratch disease with atypical presentations and aggressive radiological findings mimicking sarcoma, a potential diagnostic pitfall","volume":"92","author":"Amerstorfer","year":"2021","journal-title":"Acta Orthopaedica"},{"key":"2025082801273348000_17.5.e257341.17","doi-asserted-by":"publisher","DOI":"10.3201\/eid1209.060122"},{"key":"2025082801273348000_17.5.e257341.18","doi-asserted-by":"crossref","first-page":"2433","DOI":"10.1080\/22221751.2022.2127378","article-title":"Cat scratch disease with generalized bone lesions in an immunocompetent child","volume":"11","author":"Wang","year":"2022","journal-title":"Emerging Microbes & Infections"}],"container-title":["BMJ Case 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