儿科猫抓病:谁会全身受累?

IF 2.9 4区 医学 Q3 IMMUNOLOGY
Mayra Alejandra Martínez Lindado, María Laura Praino, Ana Caratozzolo, Analía Toledano, Cindy Toala Zambrano, María Soledad Tineo, Claudia Inés Cazes, María Marta Contrini, Eduardo Luis López
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引用次数: 0

摘要

背景:鸡巴顿氏菌是猫抓病(CSD)的病原体。虽然淋巴结病通常是主要症状,但有些患者可能会发展成严重的全身性疾病。目前还不清楚为什么有些患者会发展为全身性疾病。本研究旨在描述 CSD 儿童的临床、流行病学和实验室特征,并分析全身感染与局部感染之间的差异:通过回顾性审查阿根廷布宜诺斯艾利斯一家三级儿科医院2012年1月至2021年7月的医疗记录,确定了患者的身份。CSD病例的定义是任何临床表现与鸡疫杆菌血清学检测阳性(IgG >1/64 或 IgM 免疫荧光)相符的患者:结果:共发现 197 例患者,中位年龄为 8 岁(范围:1-17.4 岁)。最常见的临床症状是发热和淋巴结肿大。34.5%的患者(68 人)出现全身受累,最常见的表现是脾脓肿(51 人),其次是肝脓肿(23 人)、脉络膜视网膜炎(9 人)、骨髓炎(5 人)和肺炎(3 人)。侵袭性疾病患者多伴有发热(79.4% 对 50.3%)(PC 结论:CSD 必须被视为潜在的病因:必须将 CSD 视为淋巴结病的潜在病因。对发热和 C 反应蛋白升高的患者应进行评估,以排除全身性疾病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cat Scratch Disease in Pediatrics: Who Has Systemic Involvement?

Background: Bartonella henselae is the agent responsible for cat scratch disease (CSD). Although lymphadenopathy is typically the defining symptom, some patients develop potentially severe systemic compromise. It is unknown why some patients progress to systemic disease. The objective of this study was to describe the clinical, epidemiologic and laboratory characteristics of children with CSD and to analyze the differences between systemic versus localized infections.

Methods: Patients were identified by a retrospective review of medical records at a tertiary pediatric care hospital in Buenos Aires, Argentina, from January 2012 to July 2021. A CSD case was defined as any patient who presented compatible clinical findings with a positive serologic test (IgG >1/64 or IgM immunofluorescence) for B. henselae.

Results: A total of 197 patients were identified, with a median age of 8 years (range: 1-17.4 years). The most frequent clinical symptoms were fever and lymphadenopathy. Systemic involvement was present in 34.5% (n = 68) of patients and the most common presentation was splenic abscess (n = 51), followed by liver abscess (n = 23), chorioretinitis (n = 9), osteomyelitis (n = 5) and pneumonitis (n = 3). Patients with invasive disease more frequently presented with fever (79.4% vs. 50.3%) (P<0.001) and had higher C-reactive protein levels (24.9 vs. 6.7 mg/L) (P<0.001). Antibiotic therapy was administered to 95.9% (n = 187) of patients and most with systemic disease (77%) used combination treatment. Most patients recovered fully, and there were no reported deaths.

Conclusions: CSD must be considered a potential cause of lymphadenopathy. Patients with fever and elevated C-reactive protein should be evaluated to rule out systemic compromise.

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来源期刊
CiteScore
6.30
自引率
2.80%
发文量
566
审稿时长
2-4 weeks
期刊介绍: ​​The Pediatric Infectious Disease Journal® (PIDJ) is a complete, up-to-the-minute resource on infectious diseases in children. Through a mix of original studies, informative review articles, and unique case reports, PIDJ delivers the latest insights on combating disease in children — from state-of-the-art diagnostic techniques to the most effective drug therapies and other treatment protocols. It is a resource that can improve patient care and stimulate your personal research.
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