Osteomyelitis of the hip joint associated with systemic cat-scratch disease in an adult

Reported here is the case of a 29-year-old male with cervical lymphadenopat hy, fever and weight loss, followed by acute painful osteomyelitis of the l eft hip joint due to cat-scratch disease. The diagnosis was established by detection of IgG antibodies to Bartonella henselae in serum and histologic examination of a lymph node including a positive polymerase chain reaction test. Treatment consisted of clarithromycin and cefotiam for 2 weeks. Four weeks after discharge, all of the patient's symptoms had completely resolve d. Magnetic resonance imaging of the left hip joint showed marked regressio n of bone inflammation 4 months later and normalization after 8 months. Cat -scratch disease should be considered in the differential diagnosis of oste omyelitis in an adult, especially when lymphadenitis is present.