Silver B E, Bean C S
Department of Pediatric Neurology, Medical Center of Delaware.
Del Med J. 1991 Jun;63(6):365-8.
Cat scratch disease is usually benign, self-limited and without sequelae. Margileth has established four clinical criteria, three of which must be satisfied to make the diagnosis: 1) a history of animal exposure, usually kitten, with primary skin or ocular lesions; 2) regional chronic adenopathy without other apparent cause; 3) a positive cat scratch disease antigen skin test; and 4) lymph node biopsy demonstrating noncaseating granulomas and germinal center hyperplasia. Central nervous system involvement in cat scratch disease has been previously reported, although it is extremely uncommon. In a several-month period, we encountered two cases of cat scratch disease complicated by encephalopathy. The intents of this paper are twofold: 1) to briefly review the current literature on cat scratch disease, 2) to demonstrate that cat scratch disease complicated by encephalopathy presents acutely with seizures, posturing and coma and resolves rapidly with supportive care.
猫抓病通常是良性的、自限性的且无后遗症。马吉勒思制定了四条临床标准，其中三条必须满足才能做出诊断：1）有动物接触史，通常是小猫，伴有原发性皮肤或眼部病变；2）无其他明显病因的区域性慢性淋巴结病；3）猫抓病抗原皮肤试验呈阳性；4）淋巴结活检显示非干酪样肉芽肿和生发中心增生。虽然猫抓病累及中枢神经系统极为罕见，但此前已有报道。在几个月的时间里，我们遇到了两例并发脑病的猫抓病病例。本文的目的有两个：1）简要回顾关于猫抓病的当前文献，2）证明并发脑病的猫抓病急性发作时伴有癫痫、姿势异常和昏迷，经支持治疗后可迅速康复。
