Akademik Veri Yönetim Sistemi
47th Congress of European Society of Lymphology, İstanbul, Türkiye, 30 Mayıs - 02 Haziran 2024, ss.2, (Özet Bildiri)
A Rare Cause of Lymphedema:
Cat Scratch
Disease
INTRODUCTION: Cat Scratch Disease (CSD) is an
infectious disease caused by Bartonella henseleae, which progresses with
chronic granulomatous inflammation and is mostly seen in children and young
adults.. The agent is frequently transmitted to humans by cats. Local lymphadenopathy occurs with complaints such as
fever, weakness and fatigue.
CASE: A 24-year-old female patient went to hospital with
the complaint of swelling in her left hand. The patient said that he was
scratched by a stray cat two months ago; Following the development of fever and
painful swelling in the axillary region, ultrasound revealed two lymph nodes,
34x25 and 10x28 in size, with lobulated contours and necrosis in the middle,
and it was learned that lymph node excision was treated for diagnostic purposes
and antibiotic therapy with azithromycin was started.
In the pathological examination of the lymph nodes, chronic
granulomatous lymphadenitis with abscess formation compatible with CSD was
detected.
In physical examination; In the upper extremity
circumference measurements made with a tape measure at standard points, a 2 cm
swelling was detected at the hand and wrist level compared to the right side.
No limitation was detected in the shoulder joint range of motion of the
patient, who was diagnosed with Stage 2 lymphedema. Examination findings of
other systems were normal. Complex decongestive therapy was applied, including
10 sessions of manual lymph drainage, self-drainage training, multilayer
bandaging, and then a compression garment. The treatment was terminated with
self-drainage, exercise and protection recommendations.
RESULTS:
Picture 1: It can be seen that there is a difference
of 2 cm on the left the dorsal hand compared to the right side.
Table 1: Measurement Differences of Left-Right Hands
|
Standart Points |
Before Treatment (Left-Right) Difference (cm) |
After Treatment (Left-Right) Difference (cm) |
|
Middle Hand |
2,1 |
0,9 |
|
Wrist |
2 |
0,7 |
Picture 2: Left hand view before and after treatment
CONCLUSIONS:
·
Cat Scratch Disease causes damage to
lymphatic pathways due to chronic granulomatous inflammation.
• The risk of developing lymphedema increases due to
lymph node excision performed for diagnostic purposes.
• Care should be taken against lymphedema, in infectious
diseases that especially affect the lymphatic system.
• Complex decongestive therapy was effective, the edema
in the patient's hand completely subsided and fully recovered.