Axilární lymfadenitidabartonelové etiologieu dospělého, předtím zdravéhomuže - zemědělce

Axillary lymphadenitis of Bartonella etiology in a previously healthy adultmale employed in agriculture

A 35-year old male farmer, on injury to the index finger with consequent axillary lymphadenitison the right, with a mild overall inflammatory alteration (mild febrile state; BSR, CRP,leucocytosis - all increased moderately) was treated as an outpatient (cefadroxil) and thenduring hospitalization (cefadroxil + ciprofloxacin). After being a month markedly worse off,admitted to the department of hematology where within the framework of continuing differentialdiagnostics of a lymphadenoid syndrome, on the basis of anamnestic data (cat on the farm)and clinical picture, doxycycline was administered and an extirpation of the lymph node packetin the given localization. Histology was in line with cat-scratch disease and its etiology wassubsequently confirmed by serology of paired blood serum samples focused on Bartonellahenselae. The clinical state of the patient markedly improved under therapy; a month after itsbeginning he felt well subjectively, the above-mentioned markers of a systemic inflammationreturned to normal completely.

Key words:
axillary lymphadenitis - cat-scratch disease - Bartonella henselae.