Warren Alpert Medical School of Brown University, Providence, R.
Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI.
R I Med J (2013). 2023 Apr 3;106(3):52-55.
This report describes the case of a 73-year-old female with a history of a prosthetic mitral valve and breast cancer who presented with fever and confusion. Brain imaging revealed multiple ischemic infarcts, and abdominal imaging demonstrated splenic infarcts. Workup with transesophageal echocardiogram revealed a vegetation on the aortic valve, but several blood cultures had no bacterial growth. Further history revealed a recent exposure to a stray cat, and the patient was found to have positive antibodies for Bartonella henselae, the organism implicated in cat scratch disease. She was treated with the appropriate course of antibiotics, and she made a full recovery to her baseline functional status. This report emphasizes the importance of a comprehensive patient history and a broad differential diagnosis.
本报告描述了一例 73 岁女性，既往有二尖瓣假体和乳腺癌病史，表现为发热和意识混乱。脑部影像学检查显示多发性脑梗死，腹部影像学检查显示脾梗死。经食管超声心动图检查发现主动脉瓣有赘生物，但多次血培养均无细菌生长。进一步询问病史发现患者近期接触过流浪猫，且患者巴尔通体亨氏亚种的抗体检测呈阳性，该病原体与猫抓病有关。患者接受了适当疗程的抗生素治疗，完全恢复到基线功能状态。本报告强调了全面的患者病史和广泛的鉴别诊断的重要性。
