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目的 分析猫抓病 (CSD)临床病理特点、诊断要素 ,提高对CSD及其致病菌B .henselae的认识 ,减少误诊。方法 回顾 1991～ 2 0 0 2年该院临床和 (或 )病理诊断为CSD病例 2 6例 ,分析其临床、病理、治疗结果。结果 2 6例CSD患者均有猫接触史 ;均有自限性局部淋巴结肿大 ,可有发热 ;HE光镜下病理特点为淋巴结内坏死性肉芽样微脓肿形成 ;Warthin Starry染色和Brown Hopp染色可见到革兰阴性、嗜银性、多形性杆菌。结论 CSD是新近发现的、自限性的细菌性传染病。临床特点和淋巴结活检及特殊染色有助于确诊。治疗以氨基糖苷类、阿奇霉素、喹诺酮类效果好 ,必要时可考虑淋巴结穿刺或切除。
Objective To analyze the clinicopathological characteristics and diagnostic factors of cat scratch disease (CSD) and to improve the understanding of CSD and its pathogenic bacterium Chenhenlae to reduce the misdiagnosis. Methods The clinical and (or) pathological findings of 26 cases of CSD from 1991 to 2002 were retrospectively analyzed. The clinical, pathological and therapeutic results were analyzed. RESULTS: Twenty-six patients with CSD had history of cat contact. Both had self-limiting local lymph nodes and had fever. The pathological features of HE staining were necrotic granulomatous micro abscess in lymph nodes. Warthin Starry staining and Brown Hopp staining Gram-negative, argentophilic, pleomorphic bacilli can be seen. Conclusion CSD is a newly discovered, self-limiting bacterial infection. Clinical features and lymph node biopsy and special staining help confirm the diagnosis. Treatment with aminoglycosides, azithromycin, quinolone effect, if necessary, can consider lymph node puncture or removal.