巴托内拉汉塞拉三膜内心炎呈现为源不明的发烧
Zoë Wohlgenant1, Megan Hansen2, Molly McDonough2
1Infectious Diseases Division, Duke University School of Medicine, Durham, North Carolina, USA zvw@duke.edu.
BMJ case reports
|February 4, 2026
概括
由Bartonella henselae引起的猫病 (CSD) 可以呈现为培养负内心炎. 早期诊断依赖于怀疑B. henselae在患有未知来源的发烧和猫暴露的患者中,即使没有典型症状.
科学领域:
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
- 内部医学 内部医学
背景情况:
- 由Bartonella henselae引起的猫病 (CSD) 是不常见的来源不明发烧 (FUO) 的原因.
- 在CSD中,内脏器官参与是罕见的,这使得诊断具有挑战性.
研究的目的:
- 报告一个作为培养负性内心炎的CSD病例.
- 突出考虑巴托内拉汉塞拉在非典型呈现的FUO中的重要性.
主要方法:
- 一名中年妇女患有长期发烧和夜间出汗,接受了广泛的感染性检查.
- 诊断评估包括成像 (超声波,TEE),巴顿氏菌的血清学测试和广泛的病原体查.
- 治疗涉及多西环素和利法的组合.
主要成果:
- 患者出现炎症标志物升高,脏病变和盆腔液收集.
- 巴托内拉 henselae IgG 血清学强烈阳性,TEE 显示三管植被.
- 随着多西环素和利法的治疗,症状迅速消失.
结论:
- 中心心脏病可以表现为右侧内心炎,即使没有经典的淋巴腺病.
- 详细的暴露史,特别是与猫接触,对于诊断非典型的巴顿氏菌感染至关重要.
- 血清或分子检测对于诊断Bartonella henselae至关重要,因为它具有苛刻的性质和难以培养.
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