Eroğlu Cafer, Candir Nihat, Dervişoğlu Adem, Kefeli Mehmet
Ondokuz Mayis Universitesi Tip FakOltesi, Klinik Mikrobiyoloji ve Infeksiyon Hastaliklan Anabilim Dali, Samsun.
Mikrobiyol Bul. 2007 Oct;41(4):603-6.
Cat scratch disease (CSD) which is usually seen in children and young adults and characterized by self limited lymphadenopathy, is caused by Bartonella henselae. In this report, a 30-year-old male patient who was admitted to the outpatient clinic with the complaint of lymphadenopathy, was presented. Erythrocyte sedimentation rate and C reactive protein values of the patient were normal, and anti-HIV, Brucella agglutination and anti-toxoplasma IgM and IgG tests were negative. No bacterial growth was detected in the cultures of repetetive blood samples and biopsy specimens taken from the right axillar lymph node. This might probably be due to the prior antibiotic therapy (ciprofloxacin and cefazolin) given by another health center. Polymerase chain reaction performed with biopsy specimen by using 27f and 1525r primers, also yielded negative result. CSD was diagnosed depending on the history of direct contact with a cat (being scratched and bitten), together with the clinical features and histopathologic findings (necrotizing granulomatous inflammation concordant with CSD). Lymphadenopathies of patient had completely resolved after five-days oral azithromycin therapy. Since CSD is a rare infection of adults, it should be taken into consideration in the patients who suffer from silent lymphadenopathy and present with the history of direct contact with cats.
猫抓病(CSD)常见于儿童和年轻人,以自限性淋巴结病为特征,由汉赛巴尔通体引起。在本报告中,介绍了一名30岁男性患者,因淋巴结病主诉就诊于门诊。患者的红细胞沉降率和C反应蛋白值正常,抗HIV、布鲁氏菌凝集试验以及抗弓形虫IgM和IgG检测均为阴性。从右侧腋窝淋巴结采集的重复血样和活检标本培养物中未检测到细菌生长。这可能是由于另一家医疗中心先前给予的抗生素治疗(环丙沙星和头孢唑林)。使用27f和1525r引物对活检标本进行聚合酶链反应,结果也为阴性。根据与猫直接接触的病史(被抓伤和咬伤),以及临床特征和组织病理学发现(与CSD一致的坏死性肉芽肿性炎症),诊断为CSD。患者的淋巴结病在口服阿奇霉素治疗五天后完全消退。由于CSD是成人罕见的感染,对于患有无症状淋巴结病且有与猫直接接触病史的患者应予以考虑。