Bülent KARA, Sait UÇAN, Berkant BASIM, Cengiz ERÇİN, Emin Sami ARISOY

Hepatosplenik kedi tırmığı hastalığı: Vaka sunumu

On gündür düşmeyen ateş, sağ koltuk altında lenfadenopati ve splenomegali nedeniyle tetkik edilen on yaşındaki erkek hastada karın ultrasonografisinde dalakta mikroapseler saptandı. Hastada kedi tırmalaması öyküsü vardı. Tutulan lenf bezinin histopatolojik incelemesinde kedi tırmığı hastalığıyla uyumlu bulgular saptandı. Rifampisin ve trimetoprim-sulfametoksazol tedavisi ile klinik ve laboratuar iyileşme sağlandı. Düşmeyen ateş ve/veya bölgesel lenfadenopatiyle başvuran vakalarda hepatosplenik kedi tırmığı hastalığı da düşünülmelidir.

Anahtar Kelimeler:

Rifampin, Trimetoprim-sulfametoksazol kombinasyonu, Nedeni bilinmeyen ateş, Kedi-tırmığı hastalığı

Hepatosplenic cat-scratch disease: Case report

A ten-year old boy admitted to our clinic for fever of unknown origin, right axillary lympadenopathy and splenomegaly. Abdominal ultrasonography showed microabscesses in the spleen and we suspected about cat-scratch disease. History of cat contact was positive. The histo-pathologic investigation of the lymph node revealed the typical signs compatible with cat-scratch disease. The patient was treated with rifampin and trimethoprim-sulfamethoxazole and had clinical and laboratory recovery. We report our patient to emphasize that the clinicians must be aware of hepatosplenic cat scratch disease in patients who have regional lympadenopaty and/or fever of unknown origin.

Keywords:

Rifampin, Trimethoprim-Sulfamethoxazole Combination, Fever of Unknown Origin, Cat-Scratch Disease,

___

1. Anonymous. Cat-scratch disease in children-Texas, Septembeı 2000-August 2001 (Editorial). MMWR 2002; 51:212-4.
2. Maguina C, Gotuzzo E. Bartonellosis (new and old). Infecl Dis Clin North Am 2000; 14:1-22.
3. Maurin M, Raoult D. Bartonella infections; diagnostic and management issues. Curr Op Infect Dis 1998; 11:189-93.
4. Hamilton DH, Zangwill KM, Hadler JL, Carter ML. Cat-scratch disease-Connecticut, 1992-1993. J Infect Dis 1995; 172:570-3.
5. Anonymous. Epidemiologic notes and reports; encephalitis associated with cat scratch disease (Editorial). MMWR 1994; 43:915-6.
6. Arisoy ES, Correa AG, Wagner ML, Kaplan SL. Hepatosplenic cat-scratch disease in children: selected clinical features and treatment. Clin Infect Dis 1999; 28:778-84.
7. Dalton MJ, Robinson LE, Cooper J, Regnery RL, Olson JG, Childs JE. Use of Bartonella antigens for serologic diagnosis of cat-scratch disease at a national referral center. Arch Intern Med 1995; 155:1670-6.
8. Sander A, Berner R, Ruess M. Serodiagnosis of cat scratch disease; response to Bartonella henselae in children and a review of diagnostic methods. Eur J Clin Microbiol Infect Dis 2001; 20:392-401.
9. Bass JW, Vincent JM, Person DA. The expanding spectrum of Bartonella infection. Pediatr Infect Dis J 1997; 16:163-79.
10. Margileth AM. Antibiotic therapy for cat-scratch disease; clinical study of therapeutic outcome in 268 patients and review of the literature. Pediatr Infect Dis J 1992; 11:474-8.