Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A Case of Cat Scratch Disease Confirmed by Polymerase Chain Reaction for Bartonella henselae DNA

Bartonella henselae DNA에 대한 PCR 검사로 확진된 Cat Scratch Disease 1례

  • Chung, Ju-Young (Departments of Pediatrics, Sanggyepaik Hospital, Inje University College of Medicine) ;
  • Koo, Ja Wook (Departments of Pediatrics, Sanggyepaik Hospital, Inje University College of Medicine) ;
  • Kim, Sang Woo (Departments of Pediatrics, Sanggyepaik Hospital, Inje University College of Medicine) ;
  • Yoo, Young Sam (Departments of Otolaryngology, Sanggyepaik Hospital, Inje University College of Medicine) ;
  • Han, Tae Hee (Departments of Diagnostic Laboratory Medicine, Sanggyepaik Hospital, Inje University College of Medicine) ;
  • Lim, Seong Jig (Departments of Pathology, Sanggyepaik Hospital, Inje University College of Medicine)
  • 정주영 (인제대학교 의과대학 상계백병원 소아과) ;
  • 구자욱 (인제대학교 의과대학 상계백병원 소아과) ;
  • 김상유 (인제대학교 의과대학 상계백병원 소아과) ;
  • 유영삼 (인제대학교 의과대학 상계백병원 이비인후과) ;
  • 한태희 (인제대학교 의과대학 상계백병원 진단검사의학과) ;
  • 임성직 (인제대학교 의과대학 상계백병원 병리과)
  • Received : 2004.12.06
  • Accepted : 2005.03.11
  • Published : 2005.07.15
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Abstract

We report a case of cat scratch disease (CSD) caused by Bartonella henselae in a 14-year-old boy who developed lymphadenopathy in the right cervical area, after a raising canine pet for 10 months. The cervical lymphadenopathy persisted for 14 days. Immunofluorescent antibody testing for B. henselae with the patient's serum was 1:64 positive. Polymerase chain reaction (PCR) analysis using the patient's lymph node aspirates for B. henselae DNA was also positive. This is the first case of cat scratch disease confirmed by PCR for B. henselae DNA in children.

CSD는 고양이에 긁히거나 물린 다음에 발생하는 자가제한적 국소 림프선염을 증상으로 하는 질환이다. CSD는 소아와 성인에서 비교적 흔한 인수 공통질환이며, 특히 소아 연령의 림프선염과 원인 불명열의 중요한 원인으로 알려져 있다. CSD는 고양이 벼룩에 존재하는 배설물에 있는 B. henselae가 고양이의 발톱이나 이빨에 물리면서 인체에 접종되는 것으로 여겨지지만 감염 경로는 아직 확실하지 않다. B. henselae는 고양이 벼룩 뿐 아니라 개벼룩, 쥐이 및 진드기 등의 다양한 매개 곤충에 존재하여 다양한 가축과 야생동물을 감염시킨다. 최근에는 고양이 벼룩에 교차 감염되는 애완용 개가 중요한 중간 숙주로 대두되었다. CSD는 애완용 개나 고양이와 접촉하거나 긁힌 기왕력과 전형적인 임상증상, 조직 소견, 혈청학적 검사에 의해 주로 진단되어 왔지만 최근에는 PCR을 이용하여 최종 진단을 하게된다. 저자들은 10개월간 애완용 개를 키웠던 14세 남아에서 진단된 CSD 1례를 보고하는 바이다. 본 연구는 국내 소아에서 PCR로 진단된 최초의 CSD 증례인 점에 의의가 있다. 환아의 발열과 경부 림프선염은 10일 정도 지속되었으나 특별한 치료를 하지 않고 회복되었다. 환자의 혈청에 대해 시행한 B. henselae 간접면역 형광법 검사는 1 : 64 양성이었으며 경부 림프선 흡인물을 대상으로 시행한 PCR 검사에서 B. henselae DNA의 존재가 확인되었다.

Keywords

References

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