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Ann Intern Med. 1993 Mar 1;118(5):331-6.

Syndrome of Rochalimaea henselae adenitis suggesting cat scratch disease.

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1
Wilford Hall USAF Medical Center, Lackland AFB, Texas.

Abstract

OBJECTIVE:

To describe a clinical syndrome of cat scratch disease caused by Rochalimaea henselae, including methods for isolation of the organism from tissue and for identification.

DESIGN:

Case series.

SETTING:

U.S. Air Force referral hospital infectious diseases clinic.

PATIENTS:

Two previously healthy patients.

MAIN MEASUREMENTS AND RESULTS:

Two immunocompetent patients who had handled cats developed unilateral upper-extremity adenitis associated with a distal papular lesion and fever. The adenitis and distal lesions persisted and progressively worsened. Cultures of the involved lymph nodes from both patients grew R. henselae, a recently described organism associated with bacillary angiomatosis and peliosis hepatis in human immunodeficiency virus-infected patients and with bacteremia in immunocompromised and immunocompetent hosts. The organism was characterized as oxidase negative and X-factor dependent and had a characteristic pattern in analysis of whole-cell fatty acids differing from Afipia felis, a bacterium that has been associated with cat scratch disease. The identity of the isolate was confirmed by analysis of whole-cell fatty acids using gas chromatography and by amplification of the citrate synthetase gene sequence and analysis of the polymerase chain reaction-amplified product. The organisms were broadly susceptible to a variety of antimicrobials by broth microdilution; however in-vitro resistance to first-generation cephalosporins correlated with clinical failure of therapy.

CONCLUSION:

Rochalimaea henselae can be a cause of cat scratch disease in immunocompetent patients.

PMID:
8430978
[Indexed for MEDLINE]

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