Department of Neurology, Hokkaido Neurosurgical Memorial Hospital, Japan.
Department of Neurology, Japanese Red Cross Asahikawa Hospital, Japan.
Intern Med. 2022 Oct 15;61(20):3115-3120. doi: 10.2169/internalmedicine.9047-21. Epub 2022 Mar 19.
Cat scratch disease (CSD) is a zoonotic infection caused by Bartonella henselae typically resulting in self-limited regional lymphadenopathy. Encephalitis is a complication with a supposedly benign prognosis, but we encountered an exceptional case. A 19-year-old Japanese woman presented with status epilepticus. She was diagnosed with CSD-associated encephalitis based on her history of contact with a kitten and a high titre of serum IgG to B. henselae. Multimodal treatment ameliorated her encephalitis, but neurological sequelae including spastic paraparesis, persisted. After several months, she developed age-disproportionate parkinsonism inconsistent with a neurodegenerative disease. In conclusion, CSD-associated encephalitis can result in severe neurological sequelae and post-encephalitic parkinsonism.
猫抓病（CSD）是由巴尔通体属的亨氏巴尔通体引起的一种人畜共患病，通常导致自限性区域性淋巴结病。脑炎是一种并发症，预后通常良好，但我们遇到了一个例外病例。一名 19 岁的日本女性因癫痫持续状态就诊。根据她接触小猫的病史和血清 IgG 对 B. henselae 的高滴度，她被诊断为猫抓病相关性脑炎。多模式治疗改善了她的脑炎，但包括痉挛性截瘫在内的神经后遗症仍持续存在。几个月后，她出现了与神经退行性疾病不一致的与年龄不成比例的帕金森病。总之，猫抓病相关性脑炎可导致严重的神经后遗症和脑炎后帕金森病。
