The fever of the "shoveling feces official" persisted, but it was actually caused by the "masturbating cat"
2023-11-20
In recent years, "masturbating cats" and "sucking cats" have become the signature actions of pet lovers, while at the same time, the exposure and risk of zoonotic diseases have increased. In recent years, the incidence rate of cat scratch disease has increased year by year, but its clinical manifestations are lack of specificity, and the misdiagnosis rate is extremely high. So what kind of disease is "cat scratch disease"? Mr. Zhu, a 34 year old seafood sales boss who has been serving as a "shovel fecal official" for over a month, has a fever and multiple lumps throughout his body. He works with seafood every day and often gets stabbed by fresh seafood. Two months ago, a relative took care of a cat in his own home. Mr. Zhu had a great fondness for this cat, and he worked hard on aquatic products every day. At night, he returned home to work as a "shovel poop official". Mr. Zhu recalled that when the cat first came home, it was quite unfamiliar. It was scratched on the back of its hand while "masturbating" and there was bleeding at the time. However, Mr. Zhu considered it to be a domestic cat and did not seek medical attention in a timely manner or receive vaccinations. Twenty days before the visit, Mr. Zhu discovered a lump protruding from his right elbow, accompanied by pain. He thought he had been stabbed by aquatic products, but he didn't pay much attention at the time; Ten days ago, there was also a noticeable lump in his armpit, which made him a bit nervous. However, due to the busy store, the pain was tolerable, so life went on as usual. But the night before the visit, the fever suddenly persisted, and the pain of a ping-pong ball sized lump became more pronounced. Mr. Zhu urgently came to the Zidong Hospital of Jiangsu Provincial Traditional Chinese Medicine Hospital for medical treatment under the persuasion of his family. The doctor gave him a lymph node ultrasound and asked for a detailed medical history. He learned that the patient had a history of contact with fresh aquatic products and a history of cat scratch, so he suggested that the patient go to the infection department. The diagnosis of "cat scratch disease" was actually caused by "Meow Star Man". The infection department combined with the patient's epidemiological history of cat scratch and the enlargement of lymph nodes on the same side of the scratch, first considered "cat scratch disease". However, considering that the patient has a history of aquatic stab wounds, are they infected with other special pathogens? Therefore, under the premise of sufficient communication with the patient, the infection department conducts puncture of the supratrochlear lymph nodes, and submits them for pathological and metagenomic examination. The results of the macro gene showed Bartonella hansi, positive for EBV-DNA, and the pathological results of lymph node biopsy indicated "cat scratch disease". The diagnosis of "cat scratch disease" is clear, and it is complicated with EB virus infection. The treatment plan is to choose oral azithromycin and oral antiviral therapy in combination with valaciclovir. It is recommended that patients receive rabies vaccine on time and seek medical attention from relevant departments in case of any discomfort. After 8 days of follow-up, the patient showed significant reduction in local lymph nodes and disappearance of pain. When getting scratched or bitten while masturbating a cat, it is important to be vigilant that there may be scratches or bites when interacting with the cat. If symptoms such as fever and enlarged lymph nodes occur during this process, it may be a non-specific disease - "cat scratch disease". Dr. Che Junyong, Deputy Director of the Infectious Diseases Department at Zidong Hospital of Jiangsu Province Hospital of Traditional Chinese Medicine, introduced that cat scratch disease (CSD), also known as "cat scratch fever", is a self-limiting disease caused by Bartonella Hanzi infection. Bartonella is a Gram negative bacterium. It is usually caused by cat scratches, bites, or close contact with cats, and is not transmitted from person to person. Common symptoms include skin damage, enlarged lymph nodes, and some patients may have fever, redness, swelling, and pain at the wound site. Some may also experience loss of appetite and swallowing
Edit：GuoGuo Responsible editor：FangZhiYou
Source：gmw.cn
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