Mennini Maurizio, Valentini Diletta, Di Camillo Chiara, Vittucci Anna C, Grandin Annalisa, Lancella Laura, Bartuli Andrea, Villani Alberto
Bambino Gesù Children's Hospital, Rome, Italy -
Bambino Gesù Children's Hospital, Rome, Italy.
Minerva Pediatr. 2019 Oct;71(5):415-419. doi: 10.23736/S0026-4946.16.04414-5. Epub 2016 Mar 23.
Symptomatic Bartonella henselae infection is considered rare in Europe. Cat fleas transmit the microorganism between cats, but their role in transmission of B. henselae to humans has not been defined. The aim of our study was to perform a retrospective study of detected cases at our Hospital.
We retrospectively analyzed data of all children showing lymphadenopathy and a 4-fold increase in specific IgM for B. henselae over the period from June 2010 to May 2015. We therefore examined clinical data, laboratory exams in order to achieve a description of the expression of Bartonella infection in our series: age, geographical area of origin, symptoms, laboratory exams, the seat of the swelling lymph nodes with ultrasound description, and data on biopsy of lymph node when performed.
We could identify a total of 7 patients (4 females, range of age: mean age 8.75±2.87 SD): three cases in 2011 and 1 case per year in 2010, 2012, 2013 and 2014 with an average distance between one case and the sequent of 246.16±214.54 days. All patients came from small towns with no preference between the inland and coastal areas. The infection was characterized only by lymphadenopathy with nonspecific alterations at blood tests and with no history of cat scratch.
By our experience, Bartonella infection presents as a seasonal disease with increased incidence in autumn, with peaks in October, and a decrease after spring. In conclusion, infection with B. henselae is an issue to keep in consideration in all cases of lymphadenopathy, especially in children coming from small towns even without a declared cat scratch.
有症状的汉赛巴尔通体感染在欧洲被认为较为罕见。猫蚤在猫之间传播这种微生物,但其在汉赛巴尔通体传播给人类过程中的作用尚未明确。我们研究的目的是对我院检测到的病例进行回顾性研究。
我们回顾性分析了2010年6月至2015年5月期间所有出现淋巴结病且汉赛巴尔通体特异性IgM升高4倍的儿童的数据。因此,我们检查了临床数据、实验室检查结果,以便描述我们系列中巴尔通体感染的表现:年龄、原籍地理区域、症状、实验室检查、超声描述的肿大淋巴结部位,以及进行淋巴结活检时的数据。
我们共识别出7例患者(4名女性,年龄范围:平均年龄8.75±2.87标准差):2011年有3例,2010年、2012年、2013年和2014年每年各有1例,病例之间的平均间隔为246.16±214.54天。所有患者均来自小镇,内陆和沿海地区无偏好。感染仅表现为淋巴结病,血液检查有非特异性改变,且无猫抓病史。
根据我们的经验,巴尔通体感染表现为一种季节性疾病,秋季发病率增加,10月达到高峰,春季后下降。总之,在所有淋巴结病病例中,尤其是来自小镇的儿童,即使没有明确的猫抓史,汉赛巴尔通体感染也是一个需要考虑的问题。