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酒精性肝硬化患者的致命性猫抓病:一例报告

Fatal Cat Scratch Disease in Alcoholic Patient With Liver Cirrhosis: A Case Report.

作者信息

Nainshtein-Baturov Lital, Achrak Eleonora, Grabie Yisroel Y, Khan Kalim

机构信息

Department of Osteopathic Medicine, Touro College of Osteopathic Medicine, New York, USA.

Department of Internal Medicine, Northwell Health - Staten Island University Hospital, New York, USA.

出版信息

Cureus. 2024 May 19;16(5):e60609. doi: 10.7759/cureus.60609. eCollection 2024 May.

Abstract

Cat-scratch disease (CSD), a human infection resulting from species, commonly manifests as tender lymphadenopathy. Consequently, its inclusion in the differential diagnosis of fevers of unknown origin and lymphadenopathy syndromes is imperative. Typically, it manifests as self-limiting tender lymphadenopathy and does not lead to fatalities, though it may assume a more severe course in immunocompromised individuals. Diagnostic challenges often surround CSD due to its elusive nature in laboratory tests, necessitating a reliance on the clinical presentation for definitive diagnosis. This can manifest in delayed procedures and testing, which can prolong intervention and cause rapid progress of bacteria, potentially causing severe complications and death. In this case report of a 58-year-old Caucasian male, we delve into the clinical presentation and eventual fatality of CSD in a patient with liver cirrhosis, occurring in the United States. He sought care in the emergency department due to lethargy, fever, and swollen axilla following a cat scratch. Although the patient did not exhibit signs of sepsis upon admission, he rapidly progressed to sepsis and passed away within 24 hours. This case highlights the significance of timely and proactive management in individuals presenting with CSD, especially when complicated by underlying immunocompromised conditions. Early recognition, the administration of suitable antibiotics, and comprehensive supportive care are pivotal in averting fatal outcomes in such cases.

摘要

猫抓病(CSD)是一种由 种引起的人类感染,通常表现为压痛性淋巴结病。因此,在不明原因发热和淋巴结病综合征的鉴别诊断中必须考虑到它。通常,它表现为自限性压痛性淋巴结病,不会导致死亡,不过在免疫功能低下的个体中可能会呈现更严重的病程。由于猫抓病在实验室检查中难以捉摸,诊断往往具有挑战性,因此确诊依赖于临床表现。这可能表现为检查程序和检测的延迟,从而延长干预时间并导致细菌快速发展,可能引发严重并发症甚至死亡。在这份关于一名58岁白种男性的病例报告中,我们深入探讨了在美国一名肝硬化患者中猫抓病的临床表现及最终导致的死亡情况。他因被猫抓伤后出现嗜睡、发热和腋窝肿胀而到急诊科就诊。尽管患者入院时没有败血症的迹象,但他迅速发展为败血症并在24小时内死亡。该病例强调了对猫抓病患者及时、积极治疗的重要性,尤其是在合并潜在免疫功能低下情况时。早期识别、使用合适的抗生素以及全面的支持性护理对于避免此类病例的致命后果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a17/11185286/c330e87b0244/cureus-0016-00000060609-i01.jpg

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