Valor Cristhian, Huber Katherine
Internal Medicine, University of Florida College of Medicine, Gainesville, Florida, USA.
BMJ Case Rep. 2018 Jul 6;2018:bcr-2018-224378. doi: 10.1136/bcr-2018-224378.
A 28-year-old man presented to our clinic over the course of 3 weeks with symptoms that progressed from mild headaches to fever, fatigue, myalgia and an enlarged right preauricular lymph node with ipsilateral conjunctivitis and upper eyelid weakness. Our differential included Epstein Barr Virus/Cytomegalovirus mononucleosis, bacterial conjunctivitis and lymphoma. We evaluated with CBC, EBV IgM Ab, lactate dehydrogenase level and a CMV IgG Ab which were all within normal limits. During his third visit, we discovered our patient had been scratched by two stray kittens he had adopted 2 months prior. We confirmed the diagnosis with a positive IgG level and diagnosed him with cat scratch disease presenting as Parinaud's oculoglandular syndrome. He was treated with a 5-day course of Azithromycin 250 mg with definitive improvement.
一名28岁男性在3周内前来我院就诊，症状从轻微头痛发展为发热、乏力、肌痛，右耳前淋巴结肿大，伴有同侧结膜炎和上睑无力。我们鉴别诊断的疾病包括EB病毒/巨细胞病毒单核细胞增多症、细菌性结膜炎和淋巴瘤。我们进行了血常规、EB病毒IgM抗体、乳酸脱氢酶水平和巨细胞病毒IgG抗体检测，结果均在正常范围内。在他第三次就诊时，我们发现患者在2个月前收养了两只流浪小猫，被它们抓伤过。我们通过IgG水平呈阳性确诊了该病，并诊断他为表现为帕里诺眼腺综合征的猫抓病。他接受了为期5天的阿奇霉素250毫克治疗，病情得到明显改善。
