Department of Pediatrics, Women and Child Department, Hospital do Espirito Santo de Evora EPE, Évora, Portugal
Pediatrics Infectious Diseases and Immunodeficiency Unit, Department of Pediatrics, Centro Hospitalar Universitário de São João, Porto, Portugal.
BMJ Case Rep. 2024 May 10;17(5):e257341. doi: 10.1136/bcr-2023-257341.
Cat-scratch disease is a zoonosis caused by , characterised by regional lymphadenopathy. Rarer presentations, such as osteomyelitis, can occur.We present an adolescent girl with severe right lumbar pain and fever, without animal contacts or recent travels. On examination, pain on flexion of torso, movement limitation and marked lordosis were noted, but there were no inflammatory signs, palpable masses or lymph nodes. Serological investigations revealed elevated inflammatory markers. Imaging revealed a paravertebral abscess with bone erosion. Several microbiological agents were ruled out. After a second CT-guided biopsy, PCR for was positive. At this point, the family recalled having a young cat some time before. Cat-scratch disease was diagnosed, and complete recovery achieved after treatment with doxycycline and rifampicin.Cat-scratch disease is a challenging diagnosis in the absence of typical features. However, must be investigated if common pathogens are ruled out and response to therapy is poor.
猫抓病是一种由 引起的人畜共患病，其特征为区域性淋巴结病。较少见的表现，如骨髓炎，也可能发生。我们报告一例青少年女性，有严重的右侧腰痛和发热，无动物接触或近期旅行史。体格检查发现胸脊柱前屈时疼痛、活动受限和明显的脊柱后凸，但无炎症迹象、可触及的肿块或淋巴结。血清学检查显示炎症标志物升高。影像学显示椎旁脓肿伴骨侵蚀。排除了几种微生物病原体。第二次 CT 引导下活检后，PCR 检测 呈阳性。此时，患者家属回忆起在发病前一段时间曾有一只幼猫。诊断为猫抓病，经多西环素和利福平治疗后完全康复。如果排除常见病原体且治疗反应不佳，无典型特征时猫抓病的诊断具有挑战性。
