A case of atypical cat scratch disease with fever, diarrhea and cough without lymphadenopathy

症例は75歳女性.断続的な発熱･下痢･咳を主訴に来院した.血液検査では軽度の肝障害と炎症反応の上昇が認められるのみで,CT検査でも症状の原因ははっきりとはしなかった.発症2ヵ月前から,ネコを飼い始めており,血清Bartonella henselae抗体価を測定したところ,IgM40倍,IgG>512倍と高値で陽性であり,猫ひっかき病と診断した.ミノサイクリンを投与したところ,速やかに症状の改善が認められた.原因不明の発熱患者では猫ひっかき病の可能性を念頭においておくことが必要である.

A 75-year-old woman visited our hospital with a high fever, diarrhea and cough. Her blood tests showed mild liver dysfunction and elevated CRP and CT scan revealed no abnormal findings. She had kept a cat since 2 months ago. Blood tests showed high level of Bartonella henselae antibody titer and she was diagnosed with cat scratch disease. Her symptoms were rapidly improved after Minocycline administration. This study suggests that it is important to consider cat scratch disease in the differential diagnosis of fever of unknown origin.

猫ひっかき病　

発熱

下痢　

咳