巴顿菌病:猫爱的阿喀琉斯之踵

Kübra KAYNAR, Beyza Nur EKMEKÇİ, Aylin ÖZDEMİR, Neva ARSLAN, Aslıhan TÖNGEL, Afsana BAYRAMOVA
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摘要

猫抓病(CSD)是一种由革兰氏阴性细胞内杆菌(亨塞巴尔通体)引起的人畜共患疾病,几个世纪以来一直为人所知,通常导致一种良性、自限性疾病。由受感染的幼猫传染给人类的主要途径是咬伤或抓伤受感染的猫。在这里,我们报告了一例急性肾损伤(AKI)合并血管加压剂抵抗性严重低血压和全血细胞减少症的病例,该病例有被流浪猫多次抓伤的历史。根据巴尔通体病的诊断,给予环丙沙星和强力霉素治疗。巴尔通体病患者弥散性累及内脏器官(尤其是肾脏)是非常罕见的。到目前为止,已经报道了20例导致肾衰竭的病例。由于有关巴尔通体病的数据有限,临床医生对其认识不足,导致诊断延误。我们想强调未接种疫苗的猫抓史在评估AKI患者中的重要性。
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Bartonellosis: The Achilles' Heel of Cat Love
Cat scratch disease (CSD) is a zoonotic disease known for centuries caused by Gram-negative intracellular bacilli (Bartonella henselae) generally leading to a benign, self-limiting disease. The main routes of transmission for CSD from infected young cats to human beings were through biting or scratching of contaminated cats. Here, we report a case with acute kidney injury (AKI) with vasopressor-resistant severe hypotension, and pancytopenia who had a history of multiple scratches by stray kittens. The patient was treated with ciprofloxacin and doxycycline based on the diagnosis of Bartonellosis. Disseminated involvement of visceral organs (especially kidneys) in patients with Bartonellosis is very rare. Up till now, 20 cases have been reported as the cause of kidney failure. The presence of limited data about Bartonellosis makes it less recognizable among clinicians leading to delayed diagnosis. We would like to emphasize the importance of unvaccinated cat scratch history in evaluating patients with AKI.
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