上肢に発生したネコひっかき病の2例

Cat-Scratch Disease in the Upper Extremity. Reports of Two Cases

　ネコひっかき病（CSD）は若年者に好発する感染性リンパ節炎として知られている．われわれは，上肢に生じたCSDを2例経験した．2症例とも特に誘因なく上肢に有痛性のリンパ節腫脹が生じた．ネコとの接触歴を1例に認めた．血中バルトネラ抗体価は2例とも上昇し，1例では病理組織検査も併用された．本疾患の確定診断には抗体価測定が有用であった．上肢のリンパ節腫脹を診た場合には，CSDも鑑別診断におくべきである．

　Cat-scratch disease is an infectious lymphadenitis that most commonly occurs in children and adolescents. We report two cases of this disease in the upper extremity. Painful lymphadenitis around the elbow joint in the absence of trauma was prominent in both cases. There was a history of contact with a cat in one case. The serum of both patients was tested for antibodies to Bartonella henselae. The results of both patients was positive. Open biopsy was performed in one case. The serum antibody test to detect Bartonella species may allow prompt diagnosis of this disease. Cat-scratch disease should be kept in mind when lymphadenitis is encountered around the elbow joint.