猫ひっかき病に認められた網脈絡膜炎の2例

Chorioretinitis in two cases of cat-scratch disease

要約　目的：熱発または網脈絡膜炎を契機として猫ひっかき病と診断された2症例の報告。症例：いずれも男児で，それぞれ1歳4か月と8歳であった。1例には祖母宅に2匹，他の1例には自宅に3匹の飼い猫がいた。1例では1か月前から続くリンパ節腫脹と熱発があり，両眼底に境界明瞭な白色の隆起性病変が多発していた。Bartonella henselae抗体価が上昇し，猫ひっかき病と診断された。他の1例では左頸部リンパ節の腫脹が続き，B. henselae抗体価の上昇があり，小児科で猫ひっかき病と診断された。その後，左眼底に白色の隆起性病変が発見された。結論：リンパ節腫脹があり，眼底に境界明瞭な白色の隆起性病変がある症例では，猫ひっかき病の可能性がある。

Abstract.　Purpose：To report two cases who showed fever or chorioretinitis and who were diagnosed with cat-scratch disease. Cases：Both were males and were aged 1 year 4 months and 8 years respectively. Both had cats in the house or in the house of grand mother. One case showed fever and swelling of lymph nodes since one month before. Both eyes showed white elevated fundus lesions with discrete margins. Cat-scratch disease was diagnosed after detection of elevated titer for Bartonella henselae. The other case had persistent swelling of left lymph nodes in the neck,elevated titer for B. henselae and had been diagnosed with cat-scratch disease. Elevated fundus lesions were detected in the left eye later. Conclusion：Cat-scratch disease may be the underlying cause for white elevated lesions in the fundus with swelling of lymph nodes.