Smits Walter Johannes, Feucht Heinz-Hubert, Oellig Frank, Zöllner Bernhard
Praxis für Allgemeinmedizin, Hamminkeln.
Aesculabor, Hamburg.
Dtsch Med Wochenschr. 2020 Oct;145(21):1559-1561. doi: 10.1055/a-1173-4598. Epub 2020 Oct 20.
A 60 years old woman experienced a cat scratch 34 months ago on the left eyelid. Chronic, progredient skin lesions and headache developed. Treatments with cortisone, pimecrolimus, pregabalin and metamizole were not successful. After 24 months the patient complained of severe bulbus pain in the left eye, increased eye movement pain, and high photosensitivity. There were granulomatous papules in the area of the eye.
The interdisciplinary examination findings and clinical-chemical parameters were inconspicuous. A biopsy of the eyelid area revealed the detection of Delftia acidovorans by bacterial 16S-rRNA-PCR.
Treatment with piperacillin/tazobactam 3 × 4.5 g/d IV for 10 days led to rapid clinical improvement, so that the patient could be discharged after 11 days. After additional 10 months, she had no relapse and was free of complaints.
D. acidovorans has not yet appeared as a zoonotic pathogen but should be included in the case of injury by animals in the differential diagnostic considerations.
一名60岁女性34个月前左眼睑被猫抓伤。出现慢性、进行性皮肤病变和头痛。使用可的松、吡美莫司、普瑞巴林和安乃近治疗均未成功。24个月后，患者主诉左眼眼球剧痛、眼球运动时疼痛加剧以及高度光敏。眼部区域有肉芽肿性丘疹。
多学科检查结果和临床化学参数均无异常。眼睑区域活检通过细菌16S - rRNA - PCR检测到食酸代尔夫特菌。
静脉注射哌拉西林/他唑巴坦3×4.5g/d，持续10天，临床症状迅速改善，患者11天后出院。再过10个月后，她未复发且无不适症状。
食酸代尔夫特菌尚未作为人畜共患病原体出现，但在动物致伤病例中进行鉴别诊断时应予以考虑。
