小児猫ひっかき病の1例

Case of cat scratch disease in a child

要約　目的：典型的なリンパ節腫脹を伴わない視神経網膜炎を呈した猫ひっかき病（CSD）の症例を報告する。

症例：頭痛と視力低下を呈した12歳の女児。視神経網膜炎を呈し，抗Bartonella henselae IgG抗体・IgM抗体は陽性であった。CSDに対し抗菌薬とステロイドパルス療法を施行した。治療後，炎症と視力は改善した。

結論：視神経網膜炎に対する抗菌薬治療とステロイドパルス療法は有効であった。視神経網膜炎の原因疾患としてCSDを考慮に入れ，ペット飼育歴を含む詳細な問診および全身検索を行うことが重要である。

Abstract　Purpose：To report a case of cat scratch disease（CSD）associated with neuroretinitis, but without a typical swollen lymph-nodes.

Case：A 12-year-old girl presented with headache and visual loss. She had neuroretinitis and her serum tested positive for IgG and IgM specific for Bartonella henselae. She was diagnosed with CSD and was treated with a combination of antibiotics and corticosteroids. After the treatment, her visual acuity and inflammation were improved.

Conclusion：Combination therapy of antibiotics and corticosteroids for optic retinitis were effective in this case of neuroretinitis due to CSD. To diagnose CSD, the medical examination including a question about having a cat was important.