Recurrent Osteomyelitis in a Cat due to Infection with Bartonella vinsonii subsp. berkhoffii Genotype II

Abstract

A 4-year-old spayed-female Domestic Shorthair cat, obtained from a shelter as a kitten, was examined in May 2007 because of an intermittent lameness. Rectal temperature was 1021F. The cat weighed 3.3 kg. There was a focal, nonpainful, 2.5-cm-diameter firm swelling at the medial aspect of the left metatarsal region. Radiographs of the left rear leg identified lysis of the distal aspect of the 1st metatarsal bone and adjacent soft tissue swelling. Thoracic radiographs were unremarkable. Neoplasia was suspected and digital amputation was elected. Preanesthetic blood tests identified thrombocytopenia (25,000/mL; reference range, 200,000-500,000) with an adequate estimated platelet count because of clumping, mild lymphopenia (1,071 lymphocytes/mL; reference range, 1,200-8,000), mild hyperglobulinemia (5.4 g/dL; reference range, 2.3-5.3), and negative FIV and FeLV ELISA test results. The neutrophil count was 4,725/mL (reference range, 2,500-8,500) with no bands or neutrophil toxicity. Urinalysis was unremarkable.At surgery, the left medial metatarsophalangeal joint was disarticulated and the digit was removed. Histopathologic evaluation identified a mixed inflammatory response, characterized by a large number of well-differentiated plasma cells, macrophages with erythrophagocytosis and focal aggregates of neutrophils. Pyogranulomatous osteomyelitis was diagnosed. Plasma cell numbers were sufficiently high that plasma cell neoplasia was considered a plausible differential diagnosis. Fungal, acid-fast, and silver stains did not identify infectious agents. Culture of the amputated tissue was not performed. Two weeks postoperatively, an ulcer formed at the surgical site and was accompanied by moderate muscle atrophy. The distal limb became necrotic from the surgical site to the mid-tibia, which was accompanied by severe atrophy of the left rear leg to the level of the stifle and a loss of distal deep pain, which required mid femoral amputation. At no time had the cat traumatized the original incision. Despite necrosis, there was minimal to no purulent discharge and the cat never appeared overtly uncomfortable, despite rapid deterioration in the limb.In November 2007, the cat was examined because of lethargy. The cat was thrombocytopenic (97,000/mL; reference range, 175,000-600,000) and neutropenic (1,064/mL; reference range, 2,500-8,500). Urinalysis identified proteinuria and neutrophils suggestive of a urinary tract infection and the cat was treated with amoxicillin-clavulanate 62.5 mg PO q12h for 7 days. Urine culture was not performed.In February 2008, diffuse distal swelling and lameness developed in the left front leg. Radiographs identified mild soft tissue swelling and mild degenerative joint disease. The cat was treated with meloxicam 0.45 mg PO q24h for 3 days, then q72h to alleviate pain and swelling. Despite this treatment, the cat remained intermittently lame. Swelling and lameness of the left front leg again were documented by physical examination in May 2008, at which time the swelling had become firmer and ...

Relationship between the Presence of Bartonella Species and Bacterial Loads in Cats and Cat Fleas (Ctenocephalides felis) under Natural Conditions

“…Moreover, other Bartonella species, including Bartonella quintana (12,13), Bartonella bovis (14), and Bartonella vinsonii subsp. berkhoffii (15), were occasionally isolated from cats. Cat fleas (Ctenocephalides felis) are considered the major vector of feline bartonellae.…”

Bartonella henselae infection in a man with hypergammaglobulinaemia, splenomegaly and polyclonal plasmacytosis

“…However, plasmacytosis in the bone marrow and the spleen, as documented in this patient, are not known to have been described before in association with B. henselae infection. Based upon repeated interpretations by veterinary pathologists, hypergammaglobulinaemia and plasma cell infiltration of bone spanning an 18-month time frame have been reported in a cat with multifocal osteomyelitis in association with Bartonella vinsonii subspecies berkhoffii bacteraemia (Varanat et al, 2009b). Thus, infection with a Bartonella species should be included in the differential diagnostic consideration for patients with unexplained plasma cell infiltration, splenomegaly, hypergammaglobulinaemia and polyclonal or monoclonal gammopathy.…”

Infección por Bartonella henselae con compromiso de sistema nervioso central, asociado a un papiloma del plexo coroídeo

“…Ha sido propuesto que las células hematopoyéticas podrían transportar la bacteria a los tejidos periféricos, en particular, al endotelio de la microcirculación, donde iniciarían los desórdenes vasoproliferativos 2 . En animales como perros, lobos, caballos y gatos se han encontrado secuencias de ADN de B. henselae en tumores como hemangiopericitomas y angioendoteliomatosis 15,16 . Las manifestaciones de tumores vasoproliferativos por B. henselae más significativas en humanos son la angiomatosis bacilar y peliosis bacilar.…”