猫抓病诊断与鉴别诊断

The diagnosis and differential diagnosis of cat scratch disease

目的探讨猫抓病漏诊及误诊的原因。方法回顾性分析10例CSD患者资料,有猫抓伤史并作淋巴结活检作HE,PAS,抗酸,革兰氏染色及Warthin-Starry染色作诊断及鉴别诊断。结果10例中有7例查到革兰氏阴性,W-S阳性Bartonella杆菌,病理改变多为中央化脓的肉芽肿性炎症,并排除了结核,深部真菌及淋巴瘤,确诊CSD。结论病史及淋巴结病理合检可以确诊CSD,减少漏诊及误诊。

Objective To investigate the reasons for misdiagnosis of cat scratch disease. Methods The clinical pathology data from 10 cases of CSD from the 1st Affiliated Hospital of Guangxi Medical University were analyzed. All had a history of cat injury and underwent the lymph node biopsy with HE, PAS, acid-fast stain, Gram stain, and Warthin-Starry stain for diagnosis and differential diagnosis. Results There were 7 out of 10 cases which were found the Gram negative and W-S positive Bartonella bacilli. The pathological changes mainly were granuloma associated with central abscess formation, ruling out the possibility of tuberculosis, pathogenic fungi and lymphoma then we made a definite diagnosis of CSD. Conclusions Clinical history and lymph node biopsy can ultimately diagnose CSD, preventing misdiagnosis.