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Lymph-node syndrome associated with Cat-scratch disease in children treated at the Clinic of Infectious Medicine in Ostrava


Authors: L. Hozáková 1,2;  L. Rožnovský 2;  V. Janout 1
Authors place of work: Ústav epidemiologie a ochrany veřejného zdraví, Lékařská fakulta Ostravské univerzity, Ostrava 1;  Klinika infekčního lékařství, FN Ostrava 2
Published in the journal: Čes-slov Pediat 2017; 72 (5): 301-307.
Category: Original Papers

Summary

Objectives:
A retrospective evaluation of a group of nineteen patients with cat scratch diseases which is focused on epidemiological context, clinical picture, serological diagnosis and therapy.

Material and methods:
Catch-scratch disease (CSD) was considered in children within the scope of the differential diagnosis of lymphadenopathy. It was being found out injury by cat or at least contact with cat, localization of the lymph-nodes and other clinical signs. Serological diagnosis was based on detection of antibodies against Bartonella henselae by indirect immunofluorescence. It was being found out indication and duration of antibiotic therapy, duration of lymph-node syndrome and antibodies against B. henselae. Findings of granulomatous inflammation in extirpated lymph node supported suspicion of CSD.

Results:
From 2008 to 2016 nineteen children with CSD were examined at the Clinic of Infectious Medicine in Ostrava. The group consisted of twelve boys and seven girls. Fifteen out of nineteen children had contact with cat but only five children reported injury caused by cat. Cervical lymph nodes were affected the most often, in fifteen children, and four children had affected nodes in more sites. Two children had discolored skin above lymph node. Ten children had fever. Extirpation of lymph node was performed in five children, three times with finding of granulomatous and twice with granulomatous-suppurative changes. Positive IgM antibodies were detected only in twelve children. IgG antibodies were in the titres 1:64 – 1:2048. Children were treated with macrolides for 2–3 weeks.

Conclusions:
In the group of nineteen children cervical lymph nodes were affected the most often, four children had lymph nodes in more sites. Positive IgM antibodies were detected in twelve children, lymph nodes extirpation was performed five times. Macrolides were used for treatment of CSD for 2–3 weeks.

KEY WORDS:
cat scratch disease, lymph node syndrome, serology, extirpation


Zdroje

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Štítky
Neonatology Paediatrics General practitioner for children and adolescents
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