Affiliations: Department of Pediatrics, Duke University Medical
School, Durham, NC, USA | Department of Molecular Genetics and Microbiology,
Duke University Medical School, Durham, NC, USA | Center for Microbial Pathogenesis, Duke University
Medical School, Durham, NC, USA
Note: [] Correspondence: Dr. Patrick C. Seed, MD, PhD, Department of
Molecular Genetics and Microbiology and Center for Microbial Pathogenesis, Duke
University Medical School, Durham, NC, USA. Tel.: +1 919 684 9590; Fax: +1 919
681 2089; E-mail: patrick.seed@duke.edu
Abstract: Multifocal bone marrow disease due to Bartonella henselae is
rare and is typically accompanied by osteolytic disease. A 10-year-old female
presented with advanced disease, including prolonged fever, back pain, and
radiographic multifocal pelvic bone marrow enhancement without osteolysis.
Acute and convalescent serology supported the diagnosis of B. henselae
infection. However, bone marrow aspirates lacked granulomas and inflammatory
infiltrate. The patient fully recovered without specific antimicrobial therapy.
B. henselae produces a fever and pain syndrome with multifocal bone
marrow enhancement in the absence of osteolytic lesions.
Keywords: Bartonella henselae, osteomyelitis, bone marrow enhancement, children, fever of unknown origin
