PDF(Pubmed)
Abstract：
Cat-scratch disease (CSD), a human infection resulting from Bartonella 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），由巴尔通体物种引起的人类感染，通常表现为淋巴结肿大。因此,将其纳入不明原因发热和淋巴结病综合征的鉴别诊断中势在必行.通常,它表现为自限性嫩淋巴结病，不会导致死亡，尽管在免疫受损的个体中可能会出现更严重的过程。由于其在实验室测试中难以捉摸的性质，诊断挑战通常围绕CSD，需要依赖临床表现进行明确诊断。这可能表现在延迟的程序和测试中，这可以延长干预时间并导致细菌的快速发展，可能导致严重的并发症和死亡。在这个58岁白人男性的案例报告中，我们深入研究了肝硬化患者CSD的临床表现和最终病死率，发生在美国。由于嗜睡，他在急诊室寻求治疗，发烧,猫抓伤后腋下肿胀。尽管患者入院时没有出现脓毒症的迹象，他迅速发展为败血症，并在24小时内去世。这个案例突出了及时和积极管理与CSD的个人的重要性，特别是当复杂的潜在免疫受损的条件。早期识别,施用合适的抗生素，在这种情况下，全面的支持治疗对于避免致命的结果至关重要。
