Le Tallec Véronique, Abgueguen Pierre, Pichard Eric, Chennebault Jean-Marie, Bellec Véronique, Delbos Valérie, Rousselet Marie-Christine, Dib Nina, Boyer Jean
Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire, 4, rue Larrey, 49033 Angers cedex 01.
Gastroenterol Clin Biol. 2003 Feb;27(2):225-9.
The infective agent responsible for cat scratch disease, Bartonella henselae, is a rare cause of hepatic granulomatosis in immunocompetent adults. Clinical features include a prolonged fever or more typical symptoms such as lymphadenopathy associated with painful hepatomegaly and a fever following a cat scratch or bite. Images of micronodular hepatosplenic lesions on abdominal ultrasonography or computed tomography scan along with epithelioid granulomas in a liver biopsy can suggest this diagnosis. It is established with a serology by indirect immunofluorescence or by ELISA and/or the presence of Bartonella henselae DNA evidenced by PCR in the liver biopsy. We report two cases of hepatosplenic localizations of cat scratch disease in a 41-year-old woman and a 44-year-old man presenting asthenia and fever associated with a biological inflammatory syndrome and elevated liver enzymes.
引起猫抓病的病原体汉赛巴尔通体,在免疫功能正常的成年人中是肝肉芽肿病的罕见病因。临床特征包括持续发热或更典型的症状,如与疼痛性肝肿大相关的淋巴结病以及猫抓或咬伤后的发热。腹部超声或计算机断层扫描显示的微小结节性肝脾病变图像,以及肝活检中的上皮样肉芽肿,可提示该诊断。通过间接免疫荧光法或酶联免疫吸附测定法进行血清学检测,和/或通过聚合酶链反应在肝活检中证实存在汉赛巴尔通体DNA,可确诊该病。我们报告了两例猫抓病肝脾定位病例,一例为41岁女性,另一例为44岁男性,他们均表现为乏力、发热,伴有生物炎症综合征和肝酶升高。