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Bartonella Species Infections Research · Journal article
Children · August 23, 2026
Early or partial results. Treat as a signal, not a conclusion.
This is a single case report of a 10-year-old girl with multifocal Bartonella henselae osteomyelitis presenting with fever, pain, and neurological complications after cat exposure, diagnosed via serology and bone biopsy, and treated successfully with antimicrobial therapy. The report documents an atypical and rare manifestation of cat-scratch disease and highlights diagnostic challenges in distinguishing it from malignancy; it does not provide population-level evidence or comparative efficacy data.
Case report. A previously healthy 10-year-old girl who presented with fever, fatigue, limping, and progressive thigh and groin pain one month following cat-scratch exposure.. Intervention: Targeted antimicrobial therapy (specific agent not named).
10-year-old previously healthy girl with one-month history of fever, fatigue, limping, and progressive thigh and groin pain following cat-scratch exposure Bartonella henselae serological testing positive for both IgM and IgG antibodies; PCR testing of peripheral blood and bone biopsy specimen was negative MRI revealed multifocal lesions involving right femoral diaphysis, right pubic bone, and left iliac wing, with focal hepatic and splenic lesions suggestive of disseminated disease
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Clinicians evaluating multifocal bone lesions in children with cat exposure should include Bartonella henselae osteomyelitis in the differential diagnosis, as radiological appearance may mimic malignancy. Serological testing combined with histopathology rather than PCR may be needed for diagnosis, and early antimicrobial treatment appears to yield rapid clinical improvement.
A single pediatric case report describing an atypical presentation of a rare disease manifestation; establishes diagnostic criteria and treatment response but lacks comparison group or population-level evidence.
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Clinicians evaluating multifocal bone lesions in children with cat exposure should include Bartonella henselae osteomyelitis in the differential diagnosis, as radiological appearance may mimic malignancy. Serological testing combined with histopathology rather than PCR may be needed for diagnosis, and early antimicrobial treatment appears to yield rapid clinical improvement.
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Background/Objective: Bartonella henselae, the causative agent of cat-scratch disease (CSD), usually causes a self-limiting zoonotic infection. Osteomyelitis is a rare but increasingly recognized manifestation, particularly in children, and may closely mimic malignant or other infectious bone diseases. We present a case of multifocal pediatric Bartonella henselae osteomyelitis and discuss the associated diagnostic and therapeutic challenges in the context of the current literature. Case presentation: We report the case of a previously healthy 10-year-old girl who presented with a one-month history of fever, fatigue, limping, and progressive thigh and groin pain following cat-scratch exposure. During the course of the illness, she developed unilateral facial nerve palsy and Parinaud oculoglandular syndrome. Initial laboratory investigations demonstrated elevated inflammatory markers and reactive thrombocytosis. Serological testing for Bartonella henselae was positive for both IgM and IgG antibodies, whereas polymerase chain reaction (PCR) testing of both peripheral blood and the bone biopsy specimen was negative. Plain radiographs were unremarkable; however, magnetic resonance imaging (MRI) revealed multifocal lesions involving the right femoral diaphysis, right pubic bone, and left iliac wing, together with focal hepatic and splenic lesions suggestive of disseminated disease. Because of the radiological suspicion of malignancy, a femoral bone biopsy was performed and demonstrated osteomyelitis with necrosis and microabscess formation, without evidence of malignancy. Following targeted antimicrobial therapy, the patient showed rapid clinical and laboratory improvement, with progressive regression of the lesions on follow-up MRI. Conclusions: Bartonella henselae osteomyelitis should be considered in the differential diagnosis of multifocal bone lesions in children, particularly in patients with a history of cat exposure. Because the disease may closely mimic malignancy both clinically and radiologically, establishing the diagnosis requires careful integration of epidemiological, clinical, serological, radiological, molecular, and histopathological findings. Early recognition and appropriate antimicrobial treatment are associated with an excellent prognosis.
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