Skull osteomyelitis as a rare complication of cat scratch disease.

Rafee Y, et al. Avicenna J Med. 2018 Oct-Dec.


Bartonella henselae, the causative agent of cat scratch disease (CSD), is one of the most common causes of regional lymphadenitis in children. Other less common manifestations of B. henselae infection including fever of unknown origin, neuroretinitis, and osteomyelitis are being increasingly recognized. We describe a 3-year-old female with a recent history of typical CSD involving lymph nodes who developed osteomyelitis of the skull, a very rarely recognized complication of this infection.



Having spent two days getting my head crammed full of information on Bartonella from some of the leading experts, I chuckle once again at the words, “rare complication” of a disease that frankly is probably going to surpass Lyme disease in sheer numbers and devastation.  Few are studying Bartonella and fewer yet are connecting it to Lyme/MSIDS, yet so many of us have it.

I saw bold, colored pictures of Bartonella in skin, bone, brain, liver, heart, synovial fluid, blood, and the prostrate.  In other words, everywhere.  It was clearly demonstrated that Bartonella can cause long-lasting and even lethal intra-erythrocytic (inside red blood cells) bacteremia in mammals.

In the abstract above, a toddler has a true bone infection from being chronically and inadequately treated for Bartonella.  Being only 3, this study is informative in that this type of infection doesn’t take a long period of time to occur.  This next link explains that due to facial skeletal anatomy, a bone infection here is more difficult to treat. Bones involved in osteomyelitis of the skull include the mandible, frontal bone, maxilla, nasal bone, temporal bone, and skull base bones.  (Those of you with facial pain can probably identify with this)

While they state it is rare and mostly happens in third-world countries, Bart is going to blow that myth to the wind.  This link corroborates the above link in that one of the mechanisms of Bart is to compress blood vessels, causing inflammation and edema of the area it infects.  In this case, the marrow.  This of course compromises blood flood and perpetuates a ripe area for the infection to abide.  This explains why the bottoms of our feet feel like someone beat them with a hammer.

In the talks on Bart, I learned that it was all over the area when a port was removed from a patient, indicating the need for continuing treatment to clear up the Bartonella infection in the surrounding tissue.  Please share this information with your doctor.

For more on Bartonella:

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