期刊名称：Annals of Agricultural and Environmental Medicine
印刷版ISSN：1232-1966
电子版ISSN：1898-2263
出版年度：2018
卷号：25
期号：2
页码：1-4
DOI：10.26444/aaem/89547
出版社：Institute of Agricultural Medicine in Lublin
摘要：Introduction. The paper is a case report presenting Cat Scratch Disease (CSD) in a 1.5-year- old girl. Bartoneloses, including
CSD, are a group of infectious diseases which are rarely detected, therefore there are no statistical data concerning the
aetiology, and the incidence of CSD noted in Poland is low in comparison with other European countries.
Objective. The purpose of the paper is to discuss several problems related to CSD.
Materials and method. A 1.5-year-old girl who was seen in hospital for the sparing use of her left arm when crawling. X-rays
showed osteolytic lesions which radiologists described as multi-ocular cyst or infection. As neither clinical examination
nor laboratory investigations found pathological signs, the patient was followed-up on an ambulant basis. Repeated x-ray
taken 4 weeks later showed increased periosteal proliferation accompanied by pain. The baby was admitted to the Clinic but
additional investigations found no pathologies. The baby was consulted by a rheumatologist and haematologist; however,
they did not facilitate a definitive diagnosis. As the baby developed, because of a thickening of the soft tissues on the dorsal
side of the distal epiphisis in the forearm the doctors decided to inspect the condition operatively. Macroscopic examination
found brownish granulated tissue. Suction drainage was inserted and a tissue sample was tested for aerobic and anaerobic
bacteria, tuberculosis and borelliosis. The test results were negative. The baby was in good condition, was not pyrexial and
suffered from less pain. The diagnostics was further expanded and the baby tested for yersinia, chlamydia, tuberculosis and
bartonella, i.e. CSD. The postoperative wound healed soon and radiological bony lesions began to resolve. After a month,
we received a positive bartonella test result, the baby tested positively for Bartonella henselae IgG class, which confirmed
past or active infection of CSD. A repeated test for B. henselae taken 6 months later showed a lower level of antibodies.
Conclusions. It should be remembered that CSD, which is an extremely rare infection, can be diagnosed despite mediocre
clinical and radiological manifestations. Thus, in the case of infections of unexplained aetiology and mediocre manifestations
diagnostics should include testing for Bartonella henselae.
