Pediatric Hematology/Oncology and ImmunopathologyPediatric Hematology/Oncology and ImmunopathologyВопросы гематологии/онкологии и иммунопатологии в педиатрии1726-17082414-9314Fund Doctors, Innovations, Science for Children48910.24287/1726-1708-2021-20-1-136-144CLINICAL OBSERVATIONSКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯAtypical presentation of bartonellosis with hepatolienal lesionsАтипичное течение бартонеллеза с гепатолиенальным поражениемhttps://orcid.org/0000-0002-4543-2945LunyakovaM. A.ЛуняковаМ. А.
Russian Federation

Ryazan

Рязань

https://orcid.org/0000-0002-6120-4678DemikhovV. G.ДемиховВ. Г.
Russian Federation

MD., Head of Reserch center,

5B Stroiteley St., Ryazan 390029

д-р мед. наук, профессор, директор Центра,

390029, Рязань, ул. Строителей, 5В

demix777@ya.ruhttps://orcid.org/0000-0002-4210-3492InyakovaN. V.ИняковаН. В.
Russian Federation

Ryazan

Рязань

https://orcid.org/0000-0002-3778-7519PaninaE. A.ПанинаЕ. А.
Russian Federation

Ryazan

Рязань

Reserch center for hematology, oncology and immunology of Ryazan State Medical University named after academician I.P. Pavlov, Ministry of Healthcare of the Russian FederationНаучно-клинический центр гематологии, онкологии и иммунологии ФГБОУ ВО «Рязанский государственный медицинский университет им. акад. И.П. Павлова» Минздрава России210420212011361441904202119042021Copyright ©; 2021, «D. Rogachev NMRCPHOI»Copyright ©; 2021, ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России2021«D. Rogachev NMRCPHOI»ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава Россииhttps://creativecommons.org/licenses/by/4.0https://hemoncim.com/jour/article/view/489

Cat scratch disease is caused by the gram-negative intracellular bacterium Bartonella henselae (B. henselae). Human infection occurs mainly through cat scratches and bites. In typical cases, the clinical course is presented by a primary affect on the skin and regional lymphadenitis. The atypical presentation of infection can occur with fever, abdominal, ocular and neurological manifestations. A special feature of the abdominal form is the presence of solitary or multiple hypo/anechoic foci of different size and shape in the liver and spleen. B. henselae infection is one of the most common mimics of malignant lymphoma, when the spleen is involved in combination with B symptoms (weight loss, night sweats and prolonged fever). A history of recent contact with cats and diagnostic IgG titers to B. henselae indicate infection. There is no consensus on the choice of antimicrobial drug and the duration of therapy for systemic forms. The article presents its own experience in the diagnosis and treatment of such patients. The patient's parents agreed to use the information, including the child's photo, in scientific research and publications. 

Возбудителем болезни кошачьей царапины является грамотрицательная внутриклеточная бактерия Bartonella henselae (B. henselae). Заражение человека происходит преимущественно через царапины и укусы кошек. В типичных случаях клиническая картина представлена первичным аффектом на коже и регионарным лимфаденитом. Атипичная форма инфекции может протекать с лихорадкой, абдоминальными, глазными и неврологическими проявлениями. Характерной особенностью при абдоминальной форме является наличие солитарных или множественных, разных по размеру и форме, гипо-/анэхогенных очагов в печени и селезенке. Инфекция B. henselae является одной из наиболее часто имитирующих злокачественную лимфому, когда происходит вовлечение селезенки в сочетании с В-симптомами (потеря веса, ночные проливные поты и длительная лихорадка). Недавний контакт с кошками в анамнезе и диагностические титры IgG к B. henselae указывают на инфекцию. Не существует единого мнения о выборе антимикробного препарата и продолжительности терапии при системных формах. В статье представлен собственный опыт диагностики и лечения таких пациентов. Родители пациентов дали согласие на использование информации, в том числе фото детей, в научных исследованиях и публикациях. 

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