An Unusual Case of Juvenile Polymyositis Triggered by Bartonella henselae Infection

Maria Pereira^{1, 2,} , Catherine Mary Healy^{1, 3}, Carrie A. Mohila⁴ and Monica Marcus^{1, 2}

¹Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX

²Division of Allergy, Immunology and Rheumatology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX

³Division of Infectious Disease, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX

⁴Department of Pathology & Immunology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX

Cite this paper

Maria Pereira, Catherine Mary Healy, Carrie A. Mohila and Monica Marcus. An Unusual Case of Juvenile Polymyositis Triggered by Bartonella henselae Infection. American Journal of Medical Case Reports. 2018; 6(4):72-74. doi: 10.12691/AJMCR-6-4-5

Abstract

We present the first case of cat-scratch disease described to trigger juvenile polymyositis. A 15-year-old male presented with a prolonged febrile illness. He had been diagnosed with cat-scratch disease 4 weeks earlier based on his exposure to kittens and serologic testing. Treatment with antimicrobials provided partial relief. He continued to have unremitting fever and developed headache, jaw pain, blurry vision, myalgias and impaired ambulation. Imaging studies were most consistent with myositis of the lower extremities and muscles of mastication. A muscle biopsy of anterior tibialis muscle confirmed a diagnosis of polymyositis. Patient had an excellent response upon initiation of immunosuppressive treatment. Juvenile polymyositis is a rare disease and should be part of the differential diagnosis of patients presenting with prolonged fever and severe myalgias with normal muscle enzymes, particularly following a bartonella henselae infection.

Keywords

juvenile polymyositis, idiopathic inflammatory myopathy, masticatory myositis, Bartonella henselae, cat-scratch disease

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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