Cat scratch disease in children with nocturnal fever:A case report  

作　　者：Qi-Ling Yin You-Qiong Liu Hui-Min Zhang Ya-Le Zhang Shu-Min Qi Jin-Quan Wen Wei-Hua Zhang 

机构地区：[1]Department of Pediatric,Shaanxi University of Chinese Medicine,Xianyang 721000,Shaanxi Province,China [2]Department of Pediatric Respiratory,Rainbow Hospital of Xianyang(Children's Hospital of Xianyang),Xianyang 721000,Shaanxi Province,China [3]Department of Pathology,Rainbow Hospital of Xianyang(Children's Hospital of Xianyang),Xianyang 721000,Shaanxi Province,China [4]Department of Pediatric Hematology/Oncology,Rainbow Hospital of Xianyang(Children's Hospital of Xianyang),Xianyang 721000,Shaanxi Province,China [5]Department of Pediatric Intensive Care Unit,Rainbow Hospital of Xianyang(Children's Hospital of Xianyang),Xianyang 721000,Shaanxi Province,China

出　　处：《World Journal of Clinical Cases》2024年第35期6840-6847,共8页世界临床病例杂志（英文）

基　　金：Supported by Shaanxi Natural Science Foundation,No.2020SF-004.

摘　　要：BACKGROUND Cat scratch disease(CSD)is the most common human infection caused by Barto-nella henselae(B.henselae).The main manifestation is self-limited lymphaden-opathy that primarily affects adolescents,and typically resolves without treat-ment within 2-4 months.However,individuals with compromised immune systems or immunodeficiency require specific antibacterial therapy following diagnosis.Due to its low incidence,nonspecific clinical manifestations,and diagnostic limitations,this condition often poses challenges for clinicians in terms of missed diagnoses and misdiagnoses.CASE SUMMARY The child was ultimately diagnosed with CSD.The primary manifestations included nocturnal fever,enlargement of lymph nodes in the neck,axilla and groin,and suspected brucellosis;however,both brucellosis tests conducted during the course of the illness yielded negative results.Bone marrow cytology indicated stimulated proliferation.Lymph node biopsy indicated hyperplasia of lymphoid tissue in the cervical lymph nodes(right),with combined immunohisto-chemical findings indicating reactive hyperplasia.Immunohistochemical analysis revealed CD20 B(+),CD3 T(+),BCL-6(+),and BCL-2(-).CD21 FDC networks were present and Ki67 expression in the germinal center was~80%.Blood next-generation sequencing indicated B.henselae sequence number was 3.Serological test results demonstrated positive antibody response to B.henselae IgG(+),B.henselae IgM(+),Bartonella quintana(B.quintana)IgG(-)and B.quintana IgM(-),and the final diagnosis was CSD.CONCLUSION In patients presenting with fever at night and swollen lymph nodes of unknown origin,CSD should be considered.

关 键 词：Bartonella henselae Cat scratch disease Nocturnal fever CHILDREN Case report 

分 类 号：R72[医药卫生—儿科]