Schattner Ami, Uliel Livnat, Dubin Ina
Faculty of Medicine, Hebrew University, Jerusalem, Israel.
Medicine, Laniado Hospital, Sanz Medical Centre, Netanya, Israel.
BMJ Case Rep. 2018 Feb 16;2018:bcr-2017-222511. doi: 10.1136/bcr-2017-222511.
A healthy patient presented with painful skin lesions on the anterior surface of her legs. Erythema nodosum was diagnosed but all the usual causes were ruled out. The finding of bilateral enlarged axillary lymph nodes with necrosis and granulomas led to the diagnosis of infection, an unusual cause of erythema nodosum. Imaging also revealed splenomegaly and small para-aortic lymph nodes. Up to one quarter of the patients with cat-scratch disease present atypically, a considerably higher prevalence than previously reported. A comprehensive review of the literature (PubMed, since inception, all languages) revealed a remarkable array of unusual presentations which are summarised and briefly discussed.
一位健康的患者腿部前侧出现疼痛性皮肤病变。诊断为结节性红斑，但排除了所有常见病因。双侧腋窝淋巴结肿大伴坏死及肉芽肿的发现导致诊断为猫抓病感染，这是结节性红斑的一种不寻常病因。影像学检查还显示脾肿大及主动脉旁小淋巴结。高达四分之一的猫抓病患者表现不典型，其患病率比之前报道的要高得多。对文献（自创立以来的PubMed，所有语言）进行全面回顾发现了一系列不寻常的表现，现予以总结并简要讨论。
