Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel.
Ben-Shemen Specialist Referral Center, Ben-Shemen Youth Village, Israel.
J Vet Intern Med. 2022 May;36(3):1106-1112. doi: 10.1111/jvim.16415. Epub 2022 Apr 6.
A 2.5-year-old castrated male cat presented with fever and marked generalized lymphadenopathy of 4-months duration, despite treatment with amoxicillin-clavulanate/marbofloxacin. Abnormalities were not detected on complete blood count, serum chemistry, and FIV/FeLV test apart from a borderline, non-regenerative anemia. Peripheral lymph node fine needle aspirations revealed a marked increase in the percentage of intermediate- and lymphoblastic-lymphocytes in addition to reactive macrophages. Three weeks after presentation, the cat developed a severe, regenerative, immune-mediated hemolytic anemia (IMHA) which responded to immunosuppressive therapy. Fever and lymphadenopathy persisted. Peripheral lymph nodes tested positive for Bartonella henselae DNA in real-time PCR assay and sequencing. Treatment with pradofloxacin and doxycycline resulted in resolution of clinical signs, and negative PCR tests. Despite its reported low pathogenicity, B. henselae infection should also be considered in cats with protracted unexplained fever, lymphadenitis, and IMHA. Furthermore, a combination of pradofloxacin and doxycycline might be considered in cats with bartonellosis given its apparent clinical efficacy.
一只 2.5 岁已去势的雄性猫，表现为发热和长达 4 个月的全身性淋巴结肿大，尽管曾用阿莫西林克拉维酸/马波沙星治疗过。除了边界性、非再生性贫血外，全血细胞计数、血清化学和 FIV/FeLV 检测均未见异常。外周淋巴结细针抽吸显示，除反应性巨噬细胞外，中间和淋巴母细胞样淋巴细胞的百分比明显增加。就诊 3 周后，猫出现严重的再生性免疫介导性溶血性贫血（IMHA），对免疫抑制治疗有反应。发热和淋巴结病持续存在。实时 PCR 检测和测序显示外周淋巴结检测到巴尔通体亨氏 DNA 阳性。应用普多沙星和多西环素治疗后临床症状缓解，PCR 检测结果为阴性。尽管报道称其致病性较低，但对于长期不明原因发热、淋巴结炎和 IMHA 的猫，也应考虑巴尔通体感染。此外，鉴于其明显的临床疗效，对于患有巴尔通体病的猫，可能也需要考虑使用普多沙星和多西环素联合治疗。
