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題名 | Cat-Scratch Disease in Children at a Medical Center=某醫學中心兒童貓抓病的病例分析 |
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作者 | 練紹弘; 羅文聰; 李春銘; 錢新南; 朱夢麟; 王志堅; | 書刊名 | 臺灣兒科醫學會雜誌 |
卷期 | 45:5 民93.09-10 |
頁次 | 頁282-286 |
分類號 | 415.725 |
關鍵詞 | 兒童; 貓抓病; Cat-scratch disease; Bartonella henselae; |
語文 | 英文(English) |
中文摘要 | 貓抓病爲一自癒性、局部淋巴結病變,兒童爲主要發生族群。爲評估三軍總醫院中兒童貓抓病的臨床症狀、病程、診斷方式及治療情形,本文收集自民國七十五年九月一日至民國九十一年九月一日期間,收集診斷爲貓抓病的兒童共八位病患做資料分析。病患年齡分佈從4歲至13歲,平均年齡爲8.6歲,其中男性佔多數(75%),潛伏期約爲七日至一個月,診斷時間約8.5日,無死亡個案。最常見症狀爲淋巴結病變,腋下淋巴結爲最常見位置(62.5%),最常見的貓抓傷口爲手部或手指部分(62.5%)。其中三位病患靠臨床症狀及病史來診斷,三位病患經由血清學檢驗、兩位病患接受淋巴結病理檢查確認診斷。所有病患均接受抗生素治療,最常使用之抗生素爲gentamicin,抗生素治療時間約爲8.7日,平均住院日爲8日,除一位病患外,其餘在治療後,淋巴結大小皆有變小進步情形,典型兒童貓抓病長期預後佳。 |
英文摘要 | Background: Cat-scratch disease (CSD) is a well-recognized, benign, self-limited regional lymphadenopathy occurring in immunocompetent patients. Several retrospective studies have demonstrated that CSD occurs at all ages, however, the disease appears to be more common in children. We conducted a retrospective case study of CSD in children presenting at our hospital, and reviewed the relevant literature. Methods: The medical records for eight children (age range 4-13 years) diagnosed with cat-scratch disease at the Tri-service General Hospital in Taipei from September 1, 1986 to September 1, 2002 were retrospectively reviewed. Clinical manifestations, diagnostic methods, and treatment types were assessed. Results: The male gender predominated (75%); the median age was 8.6 years. The latency period ranged from 7 days to 1 month, with a median diagnostic interval of 8.5 days. There were no deaths. All patients had lymphadenopathy, and the axillary node was the most prevalent site (62.5%). The most common locations for the scratch or inoculation lesions were the hands and/or fingers (62.5%). Three patients were diagnosed from clinical symptoms and history (37.5%), three from serological study (37.5 %), and two using biopsy or aspiration (25%). All patients were given antibiotic treatment. The most commonly used antibiotic was gentamicin (75%), with the average duration of treatment 8.7 days. The average hospital stay was 8 days, with the lymph-node size reduced relative to pretreatment baseline in all except one case. Conclusion: In our experience, the long-term prognosis for children with typical CSD is favorable, and gentamicin may be a good antibiotic option. |
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