Department of Infectious Disease Department, The Third People's Hospital of Chengdu, Chengdu, China.
Digestive Endoscopy Center, Public Health Clinical Center of Chengdu, Chengdu, China.
Front Cell Infect Microbiol. 2024 Jan 15;13:1322651. doi: 10.3389/fcimb.2023.1322651. eCollection 2023.
Cat-scratch disease (CSD) is an anthropozoonotic infection caused by , and it is one of the most common causes of lymph node infections in children and adolescents. , belonging to the genus , is a common human pathogen of human beings. CSD commonly develops as a result of cat scratches and bites or when injured skin comes into contact with cat saliva. The manifestation of CSD clinically differs for each patient based on their immune system. Individuals who have healthy immune systems generally manifest minimal clinical symptoms and do not necessitate any form of treatment. However, patients who have hypo-immunity require prompt medical attention due to the potential manifestation of severe symptoms that affect multiple systems of the body. Long latency and atypical clinical manifestations are characteristics of CSD. isolation and identification are challenging procedures that require specialized equipment. There is no gold standard method for CSD diagnosis, and misdiagnosis and missed diagnosis rates are typically high. We present the case of a middle-aged male patient who developed fever, chills, anal distension, dizziness, and muscle pain for 10 days. The patient had a documented history of cat bites 1 month prior to the onset of symptoms. Following admission, he underwent an examination to determine superficial lymphadenopathy and hypoimmunity. Additionally, he had a fever during the disease. As the patient refused a needle biopsy of lymph nodes, metagenomic next-generation sequencing (mNGS) was employed and was detected in the peripheral blood. The patient was diagnosed with CSD and treated with a combination of azithromycin and doxycycline. The fever symptoms were alleviated, and the patient was ultimately discharged. As a result of this case, we suggest that mNGS be used as a crucial supplementary diagnostic tool for individuals with compromised immune systems who may have CSD, especially when conventional diagnostic methods are inconclusive.
猫抓病(CSD)是一种人畜共患感染病,由引起,是儿童和青少年淋巴结感染的最常见原因之一。属于巴尔通体属,是人类常见的病原体。CSD 通常是由猫抓伤和咬伤或受伤的皮肤接触猫唾液引起的。CSD 的临床表现因患者的免疫系统而异。免疫系统健康的个体通常表现出轻微的临床症状,不需要任何形式的治疗。然而,免疫功能低下的患者由于可能表现出影响身体多个系统的严重症状,需要及时就医。潜伏期长和不典型的临床表现是 CSD 的特征。分离和鉴定是具有挑战性的程序,需要专门的设备。CSD 诊断没有金标准方法,误诊和漏诊率通常很高。我们报告了一例中年男性患者,他出现发热、寒战、肛门肿胀、头晕和肌肉疼痛 10 天。患者在症状出现前 1 个月有猫咬伤的病史。入院后,他接受了检查,确定有浅表淋巴结病和免疫功能低下。此外,他在疾病期间发热。由于患者拒绝进行淋巴结针吸活检,因此采用了宏基因组下一代测序(mNGS),在外周血中检测到。患者被诊断为 CSD,并接受阿奇霉素和多西环素联合治疗。发热症状缓解,患者最终出院。由于该病例,我们建议对于可能患有 CSD 的免疫功能低下个体,mNGS 可作为重要的辅助诊断工具,尤其是在常规诊断方法不确定时。