Yang Zhen, Li Zhenhua, Geng Shuang, Ni Jixiang, Hu Hongling
Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Front Med (Lausanne). 2025 Aug 11;12:1611133. doi: 10.3389/fmed.2025.1611133. eCollection 2025.
We describe the first documented case of acute fibrinous and organizing pneumonia (AFOP) induced by cat-scratch disease (CSD). A 74-year-old female patient was admitted to the hospital with progressive dyspnea and dry cough for more than 1 month that did not respond to conventional antibiotic therapy. Physical examination revealed cat bite scars on the left index finger. Chest computed tomography (CT) revealed bilateral diffuse ground-glass opacities and consolidation. Percutaneous lung biopsy pathology confirmed the characteristic changes of AFOP, including fibrin 'ball 'formation in the alveolar cavity with organizing pneumonia. Polymerase chain reaction (PCR) testing was positive for ; other pathogens and autoimmune diseases were excluded. Following treatment with doxycycline and corticosteroids, the patient exhibited clinical and radiographic improvement. This case reveals the pathogenic association between CSD and AFOP for the first time, expanding the infectious etiology spectrum of AFOP and revealing the potential association between rare infections and special types of interstitial pneumonia, providing a new perspective for differential clinical diagnoses.
我们描述了首例有记录的由猫抓病（CSD）诱发的急性纤维素性机化性肺炎（AFOP）病例。一名74岁女性患者因进行性呼吸困难和干咳1个多月入院，常规抗生素治疗无效。体格检查发现左手食指有猫咬痕。胸部计算机断层扫描（CT）显示双侧弥漫性磨玻璃影和实变。经皮肺活检病理证实了AFOP的特征性改变，包括肺泡腔内纤维蛋白“球”形成伴机化性肺炎。聚合酶链反应（PCR）检测呈阳性；排除了其他病原体和自身免疫性疾病。经强力霉素和皮质类固醇治疗后，患者临床症状和影像学表现均有改善。该病例首次揭示了CSD与AFOP之间的致病关联，拓宽了AFOP的感染病因谱，揭示了罕见感染与特殊类型间质性肺炎之间的潜在关联，为临床鉴别诊断提供了新的视角。
