Smith Evan, Lawless Rob, Hoellein Andrew
Internal Medicine, University of Kentucky College of Medicine, Lexington, USA.
Cureus. 2024 Aug 14;16(8):e66840. doi: 10.7759/cureus.66840. eCollection 2024 Aug.
Cat-scratch disease (CSD), caused by (), typically presents with regional lymphadenopathy following a cat scratch or bite. We report a case of a 50-year-old man with a complex medical history including HIV, Crohn's disease, coronary artery disease, and bipolar disorder, who presented with progressively enlarging cervical lymphadenopathy associated with fever, night sweats, and myalgias. Initial evaluation suggested a neoplastic etiology, prompting extensive laboratory investigations and imaging. However, subsequent history prompted serological testing and markedly elevated antibody titers, leading to a clinical diagnosis of CSD. Empirical doxycycline therapy was initiated, resulting in the complete resolution of symptoms. This case underscores the importance of considering CSD in the differential diagnosis of lymphadenopathy, particularly in people living with HIV regardless of immunocompetency, and highlights the challenges of diagnosis and management in complex patients.
猫抓病（CSD）由（）引起，通常在猫抓或咬后出现局部淋巴结病。我们报告一例50岁男性病例，其有复杂的病史，包括HIV、克罗恩病、冠状动脉疾病和双相情感障碍，该患者出现逐渐增大的颈部淋巴结病，并伴有发热、盗汗和肌痛。初始评估提示为肿瘤病因，促使进行了广泛的实验室检查和影像学检查。然而，随后的病史提示进行血清学检测，结果显示抗体滴度显著升高，从而临床诊断为CSD。开始经验性使用强力霉素治疗，症状完全缓解。该病例强调了在淋巴结病鉴别诊断中考虑CSD的重要性，尤其是在HIV感染者中，无论其免疫功能如何，并且突出了复杂患者诊断和管理的挑战。
