Intra-nodal injection of gentamicin for the treatment of suppurated cat scratch disease's lymphadenitis
Intra-nodal injection of gentamicin for the treatment of suppurated cat scratch disease's lymphadenitis
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DOI：
10.1007/s15010-015-0797-3
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发表时间：
2016-02-01
期刊：
影响因子：
7.5
通讯作者：
Marchou, Bruno
中科院分区：
文献类型：
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作者：
Garnier, Camille;Martin-Blondel, Guillaume;Marchou, Bruno
猫抓病S淋巴结炎病程较长，需要多次穿刺针抽吸或手术引流，伴有疼痛化脓。本研究的目的是评价结内注射庆大霉素加口服阿奇霉素对化脓性CSD淋巴结炎疗效的影响。我们进行了一项单中心的回顾性研究，包括2009年1月至2014年3月连续51例CSD患者，这些患者经针吸抽吸获得脓液中的巴尔通体DNA呈阳性，并接受阿奇霉素治疗。其中26例(51%)仅接受口服阿奇霉素治疗，其中8例(31%)治愈，18例(69%)出现并发症，结内注射庆大霉素加口服阿奇霉素25例(49%)，治愈16例(%)，并发症9例(36%)。在单因素分析中，联合治疗是唯一与治愈无并发症相关的变量(对31%，P=0.01)，但在多因素分析中，这种差异没有统计学意义(OR=3.84，95%CI：0.95~15.56，P=0.06)。庆大霉素加口服阿奇霉素治疗可以改善化脓性CSD淋巴结炎患者的预后，值得进一步随机研究。
Cat scratch disease (CSD)'s lymphadenitis may have a protracted course with painful suppuration necessitating several needle aspirations or surgical drainage. The objective of this study was to evaluate the benefit of an intra-nodal injection of gentamicin add-on oral azithromycin treatment on the outcome of suppurated CSD's lymphadenitis.We performed a retrospective monocentric study including 51 consecutive patients diagnosed between Jan 2009 and Mar 2014 with suppurated CSD who had a positive PCR for Bartonella henselae DNA in pus collected from lymph node by needle aspiration, and who were treated with azithromycin.Among them, 26/51 patients (51 %) received oral azithromycin only, of whom 8 patients (31 %) were cured and 18 patients (69 %) had complications, while 25/51 patients (49 %) received an intra-nodal injection of gentamicin add-on oral azithromycin, of whom 16 patients (64 %) were cured and 9 patients (36 %) had complications. In univariate analysis, the combined treatment was the only variable related to cure without complications (64 versus 31 %, p = 0.01), but this difference did not remain statistically significant in multivariate analysis (OR = 3.84, 95 % CI: 0.95-15.56, p = 0.06).Intra-nodal injection of gentamicin add-on oral azithromycin treatment might improve the outcome of patients with suppurated CSD's lymphadenitis, deserving further randomized studies.