眼底病変を有した猫ひっかき病の7例

Seven cases of cat-scratch disease with fundus involvement

要約　目的：眼底病変を伴う猫ひっかき病7例の報告。症例：過去8年5か月の間に，血清学的にBartonella henselae抗体価が陽性である7例8眼を猫ひっかき病と診断した。男性3例3眼，女性4例5眼で，年齢は10～56歳（平均27歳）であった。初診時視力は全例が0.5以下であり，主訴は視力低下と中心暗点であった。発熱が6例，前房の炎症所見が2例，網脈絡膜の滲出斑と星芒状白斑が7例，網膜出血が6例，乳頭浮腫が5例にあった。3例には薬物投与をせず，4例には抗菌薬あるいは副腎皮質ステロイドを全身的に投与した。全例が0.7以上の最終視力を得た。結論：眼底病変を伴う猫ひっかき病は20歳以下の若年者に多く，自発的に寛解する傾向がある。眼病変が強い場合には薬物治療が必要である。

Abstract.　Purpose：To report 7 cases of cat-scratch disease with fundus manifestations. Cases：A total of 8 eyes in 7 cases were diagnosed with cat-scratch disease during the past 8 years 5 months. All were positive for Bartonella henselae antibody in the serum. The series comprised 3 eyes of 3 males and 5 eyes of 4 females. The age ranged from 10 to 56 years, average 27 years. Chief complaints included impaired visual acuity and central scotoma. Initial visual acuity was 0.5 or less in all the affected eyes. Signs and symptoms included fever 6 cases, anterior uveitis 2 cases, retinochoroidal exudates with star figure 7 cases, retinal hemorrhage 6 cases, and optic neuritis 5 cases. Three patients received no medication and 4 patients were given systemic antibiotic drug and/or corticosteroid. All the 7 cases showed final visual acuity of 0.7 or better. Conclusion：Cat-scratch disease with fundus involvement may be self-limited and tends to occur in juveniles under 20 years of age. Medication is indicated for cases with severe chorioretinitis.