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

Donà D, et al. Case Rep Pediatr. 2018.


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.



Osteomyelitis is a bone infection caused by bacteria, mycobacteria, or fungi that in the case of tick borne illness, is spread via the blood stream from a tick bite.

Bartonella is one tough mother.  Mainstream medicine always makes it out to be this benign pathogen that will go away on its own.  While this may be true for some, it is NOT true for those with tick borne illness, just ask the Bart guru, Dr. Breitschwerdt whose father died of it.  He has dedicated his life to figuring Bart out and  has developed his own testing methods as it is so illusive.  Galaxy Labs uses a Triple draw PCR plus IFA serology.  

BTW:  Standard testing tests for TWO strains when there are 32 strains and counting of Bart.  This stuff can kill you.

Bartonella is considered a vascular disease and tumor causing.  

While it caused lymphadenopathy (large lymph nodes) in a good chunk of the group in the work above, many do not have this “hallmark” symptom, just as with Lyme, many never have the “classic” bull’s eye rash.

According to Dr. Schaller

The knowledge base about both Bartonella testing and treatment borders on the disastrous. Bartonella is one of the most common infections in the world. Calling it a “coinfection” is nonsense; if anything, Lyme is the “coinfection.” It is found in vast numbers of common vectors, including dust mites, fleas, flea feces, pet saliva, and ticks. Amazingly, it can turn off or lower antibodies to Lyme disease, Babesia, Ehrlichia, Anaplasma, and even itself. Bartonella floats in blood and also enters all blood vessel walls without causing a fatal fever, and indeed actually lowers fevers. It is the ultimate stealth infection. It turns off antibodies, fevers, and immune function defense chemicals as it damages organs in 20 to 60 ways……Since Bartonella turns off the production of antibodies to infections like Babesia microti or Babesia duncani and Lyme disease, I suggest that this infection must be considered in all initial consults. 

For more on Bartonella:  (Dr. Shaller’s checklist is in the link)

Bart can cause all sorts of heart-related issues:

Eye issues:

And if the bottoms of your feet feel like someone beat them with a hammer – that’s Bart.  Got painful shins with knobs on them – that’s Bart.

Nope, you are NOT loosing your mind.  

And chiropractors, you need to know about Bart:  She had a thousand symptoms: axillary lymphadenopathy from cat scratch disease (CSD) at 12 years of age, a tibial sesamoid bone fracture, plantar fasciitis, generalized muscle/joint pain, muscle weakness, headaches, tingling, and fatigue, cervical lymph node enlargement, extremity edema, ligamentous laxity, tenosynovitis, shoulder and elbow subluxations, elbow joint crepitus, progressively worsening joint hypermobility (Beighton score 7/9), multiple joint subluxations daily, and breast cysts, meeting criteria for benign classification.

Please note the joint popping with each articulation and continual joint subluxation issue.

I had this in my knee.  Treatment completely eliminated it.



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