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首页> 外文期刊>Journal of paediatrics and child health >Atypical bartonellosis in children: What do we know?
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Atypical bartonellosis in children: What do we know?

机译：儿童的非典型Bartonellosis：我们知道什么？

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摘要

Aim: To characterise Bartonella infections in a paediatric population requiring hospital admission and review its treatment. Methods: Longitudinal observational retrospective data analysis of children and adolescents admitted with Bartonella infection at a paediatric tertiary hospital from 2010 to 2019.Results: We identified 16 cases of bartonellosis, with a mean age of 8.0 ± 4.5 years old, no sex predominance and 14 had contact with cats. Most of the cases occurred in fall and winter. Clinical presentations included osteomyelitis/arthritis (n = 9), hepatosplenic disease (n = 2), lymphadenitis (n = 2), neuroretinitis (n = 2) and encephalitis (n = 1). Clinical diagnosis was confirmed byserology (n = 16) and Bartonella DNA detection in patient's lymph nodes/hepatic lesion (n = 3). Therapeutic approach varied according to the clinical presentation: azithromycin in lymphadenitis, rifampicin plus ciprofloxacin in hepatosplenic disease, rifampicin and doxycycline in neuroretinitis, ceftriaxone in encephalitis and azithromycin, cotrimoxazole or rifampicin plus azithromycin, cefuroxime, ciprofloxacin or doxycycline in osteomyelitis/arthritis. Immunodeficiency was excluded in seven patients. Seven patients' cats were screened by veterinarians and treated when infected (n = 5).Conclusions: In these clinical presentations, where other infections may be involved, a high index of suspicion is necessary, with emphasis on the epidemiological context. The association of systemic forms with immunodeficiency did not occur in our study. The lack of recommendations for treatment of atypical infection makes the approach of these cases a challenge. Randomised control studies are essential to define the best approach in each case.
机译：目的：描述需要住院治疗的儿科人群中巴尔通体感染的特征，并回顾其治疗方法。方法：对2010年至2019年在一家儿科三级医院接受巴尔通体感染的儿童和青少年进行纵向观察回顾性数据分析。结果：我们发现16例巴尔通体病，平均年龄8.0±4.5岁，无性别优势，14例与猫接触。大多数病例发生在秋季和冬季。临床表现包括骨髓炎/关节炎（n=9）、肝脾疾病（n=2）、淋巴结炎（n=2）、神经视网膜炎（n=2）和脑炎（n=1）。临床诊断通过血清学（n=16）和患者淋巴结/肝脏病变（n=3）中巴尔通体DNA检测得到证实。治疗方法因临床表现而异：淋巴结炎的阿奇霉素、肝脾疾病的利福平加环丙沙星、神经视网膜炎的利福平和多西环素、脑炎的头孢曲松和阿奇霉素、复方新诺唑或利福平加阿奇霉素、头孢呋辛、环丙沙星或多西环素治疗骨髓炎/关节炎。7名患者排除了免疫缺陷。兽医对7名患者的猫进行了筛查，并在感染后进行治疗（n=5）。结论：在这些可能涉及其他感染的临床表现中，高度怀疑是必要的，重点是流行病学背景。在我们的研究中，系统形式与免疫缺陷没有关联。由于缺乏治疗非典型感染的建议，这些病例的治疗方法是一个挑战。随机对照研究对于确定每种情况下的最佳方法至关重要。

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