Lee S C, Fung C P, Lee N, Shieh W B
Department of Pathology, Chang Gung Memorial Hospital, Keelung, Taiwan.
J Formos Med Assoc. 1998 Aug;97(8):569-72.
We report a typical case of cat-scratch disease caused by Bartonella henselae, in Taiwan. A 20-year-old man developed right axillary lymphadenopathy 2 weeks after being scratched on his right hand by a kitten. The axillary lymphadenopathy resolved gradually and spontaneously after 10 weeks without specific treatment. Serologic tests were not done during the acute stage of the event. However, an immunofluorescent antibody test performed during the convalescent stage was positive for B. henselae antibodies, and the concentration dropped by fourfold 2 months later. Histopathologic examination of a biopsy specimen from the right axillary lymph node revealed findings characteristic of cat-scratch disease including multiple foci of microabscesses surrounded by histiocytes and infiltration by plasma cells and lymphocytes. This is the first reported case of cat-scratch disease in Taiwan, with a history of contact with a cat, a positive serologic test for B. henselae infection and characteristic histopathologic findings of cat-scratch disease which met the criteria for diagnosis.
我们报告了台湾地区一例由汉赛巴尔通体引起的典型猫抓病病例。一名20岁男性在右手被小猫抓伤2周后出现右腋窝淋巴结病。未经特殊治疗,腋窝淋巴结病在10周后逐渐自行消退。在该事件急性期未进行血清学检测。然而,恢复期进行的免疫荧光抗体检测显示汉赛巴尔通体抗体呈阳性,2个月后抗体浓度下降了四倍。对右侧腋窝淋巴结活检标本进行的组织病理学检查显示出猫抓病的特征性表现,包括多个由组织细胞包围的微脓肿灶以及浆细胞和淋巴细胞浸润。这是台湾地区首例报告的猫抓病病例,有与猫接触史、汉赛巴尔通体感染血清学检测呈阳性以及符合诊断标准的猫抓病特征性组织病理学表现。