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

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 et...

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Main Authors: D. Knafl, F. Lötsch, H. Burgmann, G. Goliasch, W. Poeppl, M. Ramharter, F. Thalhammer, C. Schuster
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2015/317260
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author D. Knafl
F. Lötsch
H. Burgmann
G. Goliasch
W. Poeppl
M. Ramharter
F. Thalhammer
C. Schuster
author_facet D. Knafl
F. Lötsch
H. Burgmann
G. Goliasch
W. Poeppl
M. Ramharter
F. Thalhammer
C. Schuster
author_sort D. Knafl
collection DOAJ
description 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.
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language English
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series Case Reports in Infectious Diseases
spelling doaj-art-5e36c92efae0498bb976a32566e806742025-02-03T01:21:37ZengWileyCase Reports in Infectious Diseases2090-66252090-66332015-01-01201510.1155/2015/317260317260Hepatosplenic Abscesses and Osteomyelitis of the Spine in an Immunocompetent Adult with Cat Scratch DiseaseD. Knafl0F. Lötsch1H. Burgmann2G. Goliasch3W. Poeppl4M. Ramharter5F. Thalhammer6C. Schuster7Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, AustriaDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, AustriaDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, AustriaDivision of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, AustriaDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, AustriaDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, AustriaDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, AustriaDivision of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University of Vienna, 1090 Vienna, AustriaWe 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.http://dx.doi.org/10.1155/2015/317260
spellingShingle D. Knafl
F. Lötsch
H. Burgmann
G. Goliasch
W. Poeppl
M. Ramharter
F. Thalhammer
C. Schuster
Hepatosplenic Abscesses and Osteomyelitis of the Spine in an Immunocompetent Adult with Cat Scratch Disease
Case Reports in Infectious Diseases
title Hepatosplenic Abscesses and Osteomyelitis of the Spine in an Immunocompetent Adult with Cat Scratch Disease
title_full Hepatosplenic Abscesses and Osteomyelitis of the Spine in an Immunocompetent Adult with Cat Scratch Disease
title_fullStr Hepatosplenic Abscesses and Osteomyelitis of the Spine in an Immunocompetent Adult with Cat Scratch Disease
title_full_unstemmed Hepatosplenic Abscesses and Osteomyelitis of the Spine in an Immunocompetent Adult with Cat Scratch Disease
title_short Hepatosplenic Abscesses and Osteomyelitis of the Spine in an Immunocompetent Adult with Cat Scratch Disease
title_sort hepatosplenic abscesses and osteomyelitis of the spine in an immunocompetent adult with cat scratch disease
url http://dx.doi.org/10.1155/2015/317260
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