Bartonella henselae osteoarthritis of the upper cervical spine in a 14-year-old boy

Mirouse, G.; Journé, A.; Casabianca, Laurent; Moreau, Philippe; Pannier, Stéphanie; Glorion, Christophe

doi:10.1016/j.otsr.2015.02.007

Cited by 13 publications

(24 citation statements)

References 16 publications

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“…As previously reported by Mirouse et al, surgical management was rare, mostly occurring after complications such as an epidural abscess or severe skeletal or articular involvement [ 72 ].…”

Section: Discussionmentioning

confidence: 99%

Osteomyelitis in Cat-Scratch Disease: A Never-Ending Dilemma—A Case Report and Literature Review

Donà

Fovino

Mozzo

et al. 2018

Case Reports in Pediatrics

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Background We performed a review of published case studies of osteomyelitis associated with cat-scratch disease to consolidate existing information on clinical presentation, diagnostic tools, therapy, and outcome, as well as presenting a case of disseminated cat-scratch disease in a 12-year-old female with skull osteomyelitis and spleen involvement. Methods A search for articles indexed in PubMed, Embase, and Google Scholar was performed with the search terms “Bartonella,” “bone,” “osteomyelitis,” “osteolytic,” and “cat-scratch disease” limited to the immunocompetent pediatric population and articles in English. Results 51 cases were identified. The average age was 7.8 years with equal sex distribution. Fever (84.3%), often with a prolonged course (64.7%), and osteoarticular pain (88.2%) were the most common clinical findings. Lymphadenopathy was present in 64.7% of patients. Vertebral body was mainly involved (51.9%). MRI (50%) and bone scintigraphy (48.1%) were favored to confirm osteomyelitis, while serology was the preferred microbiological diagnostic. Various antibiotics were prescribed in combined or sequential regimens, with median duration of therapy of 23 days. About 12.5% of patients did not receive any treatment. Most patients had excellent prognosis; in particular, all patients not receiving any therapy showed complete recovery and no recurrence of symptoms. Conclusions Bartonella henselae should be considered in differential diagnosis of localized lymphadentitis. Osteoarticular pain or limitation during cat-scratch disease in children should always be investigated for bone spreading. Owing to good prognosis, invasive procedures to obtain the bone material should be avoided. Serology is the gold standard diagnostic tool and MRI is the best radiographic technique to define bone and surrounding tissue involvement. Treatment represents a never-ending dilemma: surgical intervention or use of antibiotics is still controversial, and more studies are needed to define the best antimicrobial regimen.

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“…As previously reported by Mirouse et al, surgical management was rare, mostly occurring after complications such as an epidural abscess or severe skeletal or articular involvement [ 72 ].…”

Section: Discussionmentioning

confidence: 99%

Osteomyelitis in Cat-Scratch Disease: A Never-Ending Dilemma—A Case Report and Literature Review

Donà

Fovino

Mozzo

et al. 2018

Case Reports in Pediatrics

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“…The incidence of spinal epidural abscesses has increased due to the increasing prevalence of immunocompromized status and the aging population 30,31) . Moreover, the main source of UCEA is contiguous spread, such as that in the case of otorhinolaryngologic disease and tooth extraction [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] . Thus, 7 there may be an increasing number of patients with UCEA requiring anterior debridement and 8 stabilization.…”

Section: Discussionmentioning

confidence: 99%

“…An upper cervical epidural abscess (UCEA) can cause fatal 6 respiratory failure and/or tetraplegia, and emergent surgical intervention is required in patients with 7 progressive limb paralysis 7) . Although the transoral approach is frequently used for the treatment of 8 UCEA [8][9][10][11][12][13][14][15][16][17] , it may be inappropriate if a wide operative field and anterior stabilization are required [18][19][20][21][22][23][24][25][26][27] . For such patients, the transoral mandibular tongue-splitting approach may be useful, but it has not been used for the treatment of UCEA due to its invasiveness and possible complications [18][19][20][21][22][23][24][25][26][27] .…”

Section: Introductionmentioning

confidence: 99%

Transoral Mandibular Tongue-Splitting Approach in Upper Cervical Epidural Abscess: A Case Report and Review of the Literature

Kobayashi

Morimoto

Maeda

et al. 2020

Spine Surg Relat Res

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Introduction: The transoral mandibular tongue-splitting approach is typically performed for the treatment of upper cervical tumor and instability but has not been performed for the treatment of upper cervical epidural abscess (UCEA). We report the first case of UCEA successfully treated with a transoral mandibular tongue-splitting approach. Technical Note: A 62-year-old man who had medical histories of tracheotomy with intubation and dermatopathy due to radiation therapy for the treatment of nasopharyngeal carcinoma presented with neck pain and limb weakness. The imaging examination revealed bone erosion of C2-C4 vertebrae and abscess at the level of C2-C4, supporting a diagnosis of UCEA. The transcervical approach could not be used for treatment; therefore, the transoral mandibular tongue-splitting approach was used successfully to perform decompression, debridement, and iliac bone grafting. Subsequently, we reviewed the literature pertaining Transoral Mandibular Tongue-Splitting Approach 2 to the use of the transoral mandibular tongue-splitting approach. The approach can be invasive and cause some complications. However, no fatal complications have been reported, and all patients demonstrated a favorable neurological outcome with reduced neurological deficits. Conclusions: This case and subsequent literature review suggest that the transoral mandibular tongue-splitting approach may be effective for the improvement of neurological outcomes without fatal complications in patients with UCEA. There may be an increasing number of patients with UCEA requiring the transoral mandibular tongue-splitting approach due to the increasing prevalence of immunocompromized status and the aging population.

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“…In 2015, Mirouse et al described a 14-year-old boy who developed cervical spine osteoarthritis with osteolysis of the lateral mass of C-2 secondary to B. henselae infection. 25 The patient presented to his family physician after experiencing a cat scratch on the fifth digit associated with neck pain. The patient was treated with azithromycin, but eventually developed cervicalgia, torticollis, fever, and lymphadenopathy, with a WBC count of 7900/mm 3 and CRP level of 111 mg/L.…”

Section: Literature Reviewmentioning

confidence: 99%

Bartonella henselae infection presenting as cervical spine osteomyelitis: case report

Akbari¹,

Averill²,

Roland³

et al. 2018

Journal of Neurosurgery: Pediatrics

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Bartonella henselae is a gram-negative bacillus implicated in cat-scratch disease. Cat-scratch disease is usually self-limiting and results in local lymphadenopathy. In rare circumstances, patients may develop endocarditis, neuroretinitis, or osteomyelitis. Osteomyelitis of the cervical spine is exceedingly rare, especially in the pediatric population, and to date there have been only 4 previously reported cases of cervical spine osteomyelitis caused by B. henselae, all of which were treated surgically. In this article, the authors report the case of a 7-year-old boy who presented with neck swelling and was found to have a C2–4 paravertebral B. henselae abscess with osteomyelitis of C-3 and epidural extension. To the authors’ knowledge, this represents the first case in the literature of a cervical spine B. henselae infection managed conservatively.

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Bartonella henselae osteoarthritis of the upper cervical spine in a 14-year-old boy

Cited by 13 publications

References 16 publications

Osteomyelitis in Cat-Scratch Disease: A Never-Ending Dilemma—A Case Report and Literature Review

Osteomyelitis in Cat-Scratch Disease: A Never-Ending Dilemma—A Case Report and Literature Review

Transoral Mandibular Tongue-Splitting Approach in Upper Cervical Epidural Abscess: A Case Report and Review of the Literature

Bartonella henselae infection presenting as cervical spine osteomyelitis: case report

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