Abstract:
The hepatosplenic (HS) form of cat scratch disease (CSD) is rarely seen; however, management of the treatment is challenging for clinicians. Monotherapy or combination regimens may be preferred based on severity of cases. Along with that, there are uncertainties as to the combination and duration of antibiotics effective against the microorganisms. In this report, a 12-year-old girl diagnosed with HS-CSD and unresponsive to primary treatment with macrolide group antibiotic was presented. The patient had liver findings compatible with CSD, confirmed radiologically and pathologically, and Bartonella henselae indirect immunofluorescence assay IgG was positive at 1/2048 titre. A combination therapy for six months with doxycycline and rifampicin was initiated, and the patient was successfully treated. The preference for monotherapy or combination regimen in HS-CSD is predominantly determined by the clinician according to the severity of the patient\'s clinical findings. The effectivity of antimicrobial regimen in HS-CSD requires further investigation.
摘要:
很少见到猫抓病(CSD)的肝脾(HS)形式;然而,治疗的管理对临床医生来说是具有挑战性的。基于病例的严重程度,可以优选单一疗法或组合方案。除此之外,对微生物有效的抗生素的组合和持续时间存在不确定性。在这份报告中,我们介绍了1例诊断为HS-CSD且对大环内酯类抗生素的初级治疗无反应的12岁女孩.患者的肝脏检查结果与CSD相符,放射学和病理学证实,间接免疫荧光法IgG在1/2048滴度为阳性。开始使用多西环素和利福平联合治疗六个月,患者得到了成功治疗。HS-CSD中单药治疗或联合治疗方案的偏好主要由临床医生根据患者临床发现的严重程度确定。HS-CSD中抗菌方案的有效性需要进一步研究。