Objective To investigate the clinical features and misdiagnosed cause of cat-scratch disease to reduce the misdiagnosis rate.Methods Clinical data of 24 misdiagnosed patients with cat-scratch disease were retrospectively analyzed.Results All the 24 patients had a contact history with cats,and 20 of them had a history of cat scratch or bite.All patients visited doctors for different parts of the superficial lymph node enlargement,and on the first visit,7 patients were misdiagnosed as having lymph node tuberculosis,6 as having lymph node reactive hyperplasia,5 as having lymphoma,2 as having metastatic carcinomas of lymph node,2 as having subcutaneous masses,1 as having mixed tumor of submaxillary gland,and 1 as having inguinal hernia.All the patients were confirmed as having cat-scratch disease by lymph node biopsy after admission.All patients were cured after cutting the enlarged lymph node and applying anti-infective agents.There was no recurrence at follow-ups.Conclusion Cat-scratch disease must be considered in differential diagnosis of the local superficial lymph node enlargement,the history of close contact with the cat or dog should be taken into account,and histopathological characteristics of lymph nodes and special staining are the optimal criteria for diagnosis.%目的 探讨猫抓病的临床特点及误诊原因,以减少误诊.方法 回顾性分析24例猫抓病首诊误诊病例的临床资料.结果 本组24例均有猫接触史,20例有猫抓、咬病史.均以不同部位浅表淋巴结增大就诊,首诊误诊为淋巴结结核7例,淋巴结反应性增生6例,淋巴瘤5例,淋巴结转移癌、皮下包块各2例,颌下腺混合瘤、腹股沟疝各1例.入院后均经增大淋巴结活检病理检查确诊为猫抓病.予切除增大淋巴结及应用抗感染药物后均治愈,随访无复发.结论 对局部浅表淋巴结增大者鉴别诊断中要考虑猫抓病,注意询问患者有无猫、犬亲密接触史,淋巴结病理组织学特点及特殊染色是猫抓病诊断的金标准.
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