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Hepatosplenic Abscesses and Osteomyelitis of the Spine in an Immunocompetent Adult with Cat Scratch Disease.

Knafl D, Lötsch F, Burgmann H, Goliasch G, Poeppl W, Ramharter M, Thalhammer F, Schuster C - Case Rep Infect Dis (2015)

Bottom Line: Abdominal computed tomography showed multiple hypodense hepatosplenic lesions and osteomyelitis of the thoracic and lumbar spine with base plate fracture.Due to its variety of clinical presentations, diagnosis of CSD is challenging, especially in the absence of a history of specific exposure.Nevertheless CSD has many different and rare forms of presentations, including hepatosplenic lesions and bone involvement as shown in this case.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria.

ABSTRACT
We present an 18-year-old, immunocompetent Austrian military conscript with cervical lymphadenopathy, fever, back-pain, and persistent inflammation markers despite two weeks of antimicrobial therapy with ampicillin/sulbactam. All specific laboratory investigations for identification of a specific etiology, including blood cultures and autoantibodies, were inconspicuous. Abdominal computed tomography showed multiple hypodense hepatosplenic lesions and osteomyelitis of the thoracic and lumbar spine with base plate fracture. Based on the patient's history, clinical presentation, and radiological findings, serology for cat scratch disease (CSD) was performed and high B. henselae specific IgM and IgG antibodies were detected. Due to its variety of clinical presentations, diagnosis of CSD is challenging, especially in the absence of a history of specific exposure. This case report shall remind the physician that cat scratch disease is a common disease, mainly presenting with fever and lymphadenopathy in young patients. Nevertheless CSD has many different and rare forms of presentations, including hepatosplenic lesions and bone involvement as shown in this case.

No MeSH data available.


Related in: MedlinePlus

MRI of the spine, showing a fracture of the base plate in thoracic spine body 7, such as lesions in lumbar spine body 2.
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Related In: Results  -  Collection


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fig2: MRI of the spine, showing a fracture of the base plate in thoracic spine body 7, such as lesions in lumbar spine body 2.

Mentions: Given the ambiguous structure of the spine, a MRI was done, confirming a ventral base plate fracture of vertebral body 7 with reduction in height of 20% and bone marrow edema (Figures 2, 3, and 4). The lesions were suggestive for an underlying infectious origin as were the hepatosplenic lesions.


Hepatosplenic Abscesses and Osteomyelitis of the Spine in an Immunocompetent Adult with Cat Scratch Disease.

Knafl D, Lötsch F, Burgmann H, Goliasch G, Poeppl W, Ramharter M, Thalhammer F, Schuster C - Case Rep Infect Dis (2015)

MRI of the spine, showing a fracture of the base plate in thoracic spine body 7, such as lesions in lumbar spine body 2.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4631868&req=5

fig2: MRI of the spine, showing a fracture of the base plate in thoracic spine body 7, such as lesions in lumbar spine body 2.
Mentions: Given the ambiguous structure of the spine, a MRI was done, confirming a ventral base plate fracture of vertebral body 7 with reduction in height of 20% and bone marrow edema (Figures 2, 3, and 4). The lesions were suggestive for an underlying infectious origin as were the hepatosplenic lesions.

Bottom Line: Abdominal computed tomography showed multiple hypodense hepatosplenic lesions and osteomyelitis of the thoracic and lumbar spine with base plate fracture.Due to its variety of clinical presentations, diagnosis of CSD is challenging, especially in the absence of a history of specific exposure.Nevertheless CSD has many different and rare forms of presentations, including hepatosplenic lesions and bone involvement as shown in this case.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria.

ABSTRACT
We present an 18-year-old, immunocompetent Austrian military conscript with cervical lymphadenopathy, fever, back-pain, and persistent inflammation markers despite two weeks of antimicrobial therapy with ampicillin/sulbactam. All specific laboratory investigations for identification of a specific etiology, including blood cultures and autoantibodies, were inconspicuous. Abdominal computed tomography showed multiple hypodense hepatosplenic lesions and osteomyelitis of the thoracic and lumbar spine with base plate fracture. Based on the patient's history, clinical presentation, and radiological findings, serology for cat scratch disease (CSD) was performed and high B. henselae specific IgM and IgG antibodies were detected. Due to its variety of clinical presentations, diagnosis of CSD is challenging, especially in the absence of a history of specific exposure. This case report shall remind the physician that cat scratch disease is a common disease, mainly presenting with fever and lymphadenopathy in young patients. Nevertheless CSD has many different and rare forms of presentations, including hepatosplenic lesions and bone involvement as shown in this case.

No MeSH data available.


Related in: MedlinePlus