EDITORIAL ESPANOL:

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Hola amigos de la red, DERMAGIC de nuevo con ustedes. El gatito, bella mascota que muchos cuidamos y tenemos en nuestros hogares y que ocasiona la bien conocida ENFERMEDAD POR ARAÑAZO DE GATO. Espero que estas 32 referencias nos ilustren bien el tema,,,, y,,,, cuidado con los gatitos. 

En el attach 1 lámina ilustrativa del tema: lesión inicial, el gatito y linfadenopatía regional producto del arañazo. 

Bienvenidos a DERMAGIC: Dr. Mehmet Salih Gurel (Turquia), and Dr. Emad Elgamel (Egipto), Kelly J. Warren, M.D., Gail G.Drayton, M.D., Steve A. McClain, M.D (Estados Unidos A.)

Próxima edición: LA MINOCICLINA: LO BUENO LO MALO Y LO FEO 

Saludos,,,

Dr. José Lapenta R.,,,

 EDITORIAL ENGLISH:

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Hello friends of the net, DERMAGIC again with you. The kitten, beautiful pet of that many take care and we have in our homes and that it causes the very well-known CAT-SCRATCH DISEASE. I hope these 32 references illustrate us well the topic,,,, and,,,, care with the kittens. !!! 

In the attach 1 illustrative sheet of the topic: initial lesion, the kitten, and regional lymphadenopathy product of the scratch. 

Welcome to DERMAGIC: Dr. Mehmet Salih Gurel (Turkey), and Dr. Emad Elgamel (Egypt) Kelly J. Warren, M.D., Gail G.Drayton, M.D., Steve A. McClain, M.D (USA) 

Next edition: THE MINOCYCLINE: THE GOOD, THE BAD, AND THE UGLY. 

Greetings,,,

Dr. José Lapenta R. 

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DERMAGIC/EXPRESS(44)

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LA ENFERMEDAD POR ARAÑAZO DE GATO / THE CAT-SCRATCH DISEASE

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1.) The Cat-Scratch Disease.

2.) Cat scratch disease: detection of Bartonella henselae DNA in archival

biopsies from patients with clinically, serologically, and histologically

defined disease. 

3.) [A case of cat scratch disease identified by an elevated Bartonella

henselae antibody level using enzyme immunoassay] 

4.) Will the real agent of cat-scratch disease please stand up? 

5.) [Cat scratch disease caused by Bartonella henselae] 

6.) Hypercalcemia due to endogenous overproduction of active vitamin D in

identical twins with cat-scratch disease. 

7.) Cat-scratch disease caused by Bartonella henselae: the first case

report in Taiwan. 

8.) [Cat-scratch disease and other infections caused by Bartonella species] 

9.) Bartonella spp. as emerging human pathogens.

10.) [Bartonella henselae infection in immunocompetent patients: cat

scratch disease] 

11.) Cat-scratch disease and related clinical syndromes. 

12.) Cat-scratch disease and bacillary angiomatosis. 

13.) Detection of antibodies to Bartonella henselae in clinically diagnosed

cat scratch disease. 

14.) The expanding spectrum of Bartonella infections: II. Cat-scratch disease.

15.) Evaluation of serological response to Bartonella henselae, Bartonella

quintana and 

Afipia felis antigens in 64 patients with suspected cat-scratch disease.

16.) [Cat scratch disease and associated infections] 

17.) Cat-scratch disease simulating Histiocytosis X. 

18.) [Atypical cat-scratch disease: a case report of splenic granulomatosis] 

19.) [2 patients with atypical manifestations of cat-scratch disease]

20.) [Visceral localizations of cat-scratch disease in an immunocompetent

patient] 

21.) Serous retinal detachment of the macula associated with cat scratch

disease. 

22.) Cat scratch disease in Greece. 

23.) Cat-scratch disease--an overlooked disease in Denmark?]

24.) Prolonged Bartonella bacteremia in cats associated with cat-scratch

disease patients. 

25.) Application of polymerase chain reaction assay in the diagnosis of

orbital granuloma complicating atypical oculoglandular cat scratch disease. 

26.) Systemic cat scratch disease: hepatic and splenic involvement about 3

pediatric cases. 

27.) Bartonella clarridgeiae, a newly recognized zoonotic pathogen causing

inoculation papules, fever, and lymphadenopathy (cat scratch disease). 

28.) Coinfection with Bartonella clarridgeiae and Bartonella henselae and

with different Bartonella henselae strains in domestic cats.

29.) [Cat-scratch disease: historical, clinical, phylogenetic and taxonomic

aspects]

30.) Molecular diagnosis of cat scratch disease: a two-step approach.

31.) Antibiotic therapy for cat-scratch disease: clinical study of

therapeutic outcome in 268 patients and a review of the literature.

32.) Successful treatment of cat-scratch disease with ciprofloxacin [see

comments]

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1.) The Cat-Scratch Disease

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Source: Harrison's 14

DEFINITION AND ETIOLOGY

Typical CSD is manifested by painful regional lymphadenopathy persisting

for several weeks or months after a cat scratch. Occasionally, infection

may disseminate and produce more generalized lymphadenopathy and systemic

manifestations, which may be confused with the manifestations of lymphoma.

B. henselae is the causative agent of CSD. There is no evidence that B.

quintana or Afipia felis (originally proposed as the agent of CSD) can

cause this disease, nor are those two species carried by cats.

EPIDEMIOLOGY

Approximately 60 percent of cases of CSD in the United States occur in

children. Exposure to bacteremic young cats that either are flea-infested

or have been in contact with another cat carrying fleas poses a significant

risk of infection. Most infections are caused by a scratch and only rare

cases by a bite or by licking. Most cases occur in the warmer months, when

fleas are active. Regions of the United States where fleas are endemic have

higher rates of infection. The flea may serve to transmit infection between

cats; it is not known whether humans can be infected through the bite of an

infected flea.

CLINICAL MANIFESTATIONS

A localized papule (Fig. 165-CD3), progressing to a pustule that often

crusts over, develops 3 to 5 days after a cat scratch. Tender regional

lymphadenopathy (Fig. 165-CD4) develops within 1 to 2 weeks after

inoculation; by this time, the papule may have healed spontaneously.

Scratches are most often sustained on the hands or face, producing

epitrochlear, axillary, pectoral, and cervical lymph node involvement. The

involved nodes occasionally become suppurative; bacterial superinfection

with staphylococci or other cutaneous pathogens may develop. Although most

patients do not have fever, systemic symptoms are frequent and include

malaise, anorexia, and weight loss. Without treatment, lymphadenopathy

persists for weeks or even months and may be confused with lymphatic

malignancy. Other manifestations in apparently immunocompetent patients

include encephalitis, seizures and coma (especially in children),

meningitis, transverse myelitis, granulomatous hepatitis and splenitis,

osteomyelitis, and disseminated infection. Conjunctival inoculation may

cause Parinaud's oculoglandular syndrome, with conjunctivitis and

preauricular lymphadenopathy.

PATHOLOGY

The histopathologic hallmark of CSD is granulomatous inflammation with

stellate necrosis but no evidence of angiogenesis. Thus, infection by B.

henselae can produce two entirely different pathologic reactions, depending

on the immune status of the host: CSD or bacillary angiomatosis.

DIAGNOSIS

CSD should be suspected if the patient has a history of exposure to cats

and develops lymphadenopathy and a skin lesion. The diagnosis can be

confirmed by pathologic examination of the involved nodes. Tiny bacilli in

clusters can sometimes be seen in biopsy samples stained with

Warthin-Starry silver. The CSD skin test, in which lymph node material

obtained from patients with CSD serves as an antigen, is no longer used for

diagnosis because of concerns about the transmission of viral agents. A

specific serologic test has been developed recently and may produce a

positive result in 70 to 90 percent of patients with intact immunity. The

identification of B. henselae 16S ribosomal RNA genes in biopsy material by

PCR amplification with specific oligonucleotide primers can also be

diagnostically useful; however, these methods are not yet commercially

available. Cultures of lymph nodes, cerebrospinal fluid, or other tissues

are rarely positive.

TREATMENT

Although CSD is generally self-limited, tender regional lymphadenopathy and

systemic symptoms may be debilitating. Patients with encephalitis or other

serious manifestations should be treated with antibiotics, even though the

efficacy of such therapy is unclear. No comparative trials of antibiotic

treatment have been performed, and no anecdotal reports of treatment

failures have appeared. Several reports suggest that aminoglycoside

treatment (e.g., intravenous gentamicin at standard doses calculated to

result in therapeutic levels) is effective in patients with encephalitis

and other systemic infections. The oral agents that appear to be useful are

those that also are most effective for the treatment of bacillary

angiomatosis; they include ciprofloxacin, doxycycline, and possibly

erythromycin (at the dosages recommended for bacillary angiomatosis). Many

patients with established CSD have no apparent response to antibiotics; the

necessary duration of therapy is variable.

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2.) Cat scratch disease: detection of Bartonella henselae DNA in archival

biopsies from patients with clinically, serologically, and histologically

defined disease. 

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Author 

Scott MA; McCurley TL; Vnencak-Jones CL; Hager C; McCoy JA; Anderson B;

Collins RD; Edwards KM 

Address 

Department of Pathology, Vanderbilt University Medical Center, Nashville,

Tennessee 37232, USA. 

Source 

Am J Pathol, 149(6):2161-7 1996 Dec 

Abstract 

Serological and epidemiological studies suggest that Bartonella henselae is

the etiological agent of cat scratch disease. We designed a study to detect

B. henselae in archival biopsies by polymerase chain reaction amplification

of the 16S rRNA gene followed by Southern blot hybridization. Forty-two

histologically defined cat scratch disease biopsies and eighteen controls

were selected for blinded analysis. After testing, charts were reviewed for

clinical, immunological, and microbial evidence of infection. Results were

correlated with duration of illness and antimicrobial therapy. B. henselae

DNA was identified in 27 of 42 (64%) histologically defined patients and 23

of 34 (68%) patients defined both clinically and histologically. There were

no false positives (0 of 18). A small subset (n = 14) had cat scratch

disease serological tests performed. B. henselae was identified in 8 of 10

serologically positive patients. Polymerase chain reaction detected 50% of

our DNA-positive cases (most of these early in the clinical course).

Southern blotting of amplicons both doubled sensitivity (detecting patients

> 4 weeks into illness) and confirmed B. henselae as the causative species.

Our study strongly associates B. henselae with cat scratch disease,

suggesting that it may be the most likely etiological agent in the majority

of patients with cat scratch disease. 

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3.) [A case of cat scratch disease identified by an elevated Bartonella

henselae antibody level using enzyme immunoassay] 

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Author 

Kusaba N; Nakamura H; Yoshimoto K; Ogata H; Sata M; Tanikawa K; Kusaba A;

Yoshida H 

Address 

Second Department of Medicine, Kurume University School of Medicine. 

Source 

Kansenshogaku Zasshi, 71(10):1075-9 1997 Oct 

Abstract 

A 68-year-old male was admitted to our hospital because of fever and a

2-week history of inguinal adenomegaly. Since he owned a cat, cat scratch

disease was suspected. But it was necessary to distinguish cat scratch

disease from lymphoma type adult T-cell leukemia because he showed a high

level of antibody against HTLV-1. An excisional biopsy of the inguinal node

was performed. Histopathologic examination revealed abscess-forming

granulomatous lymphadenitis compatible with cat scratch disease. A

Warthin-Starry silver stain showed pleomorphic bacilli in the lymph node.

So we confirmed a serological response to Bartonella henselae, the

causative agent of cat scratch disease, using enzyme immunoassay (EIA). The

IgG antibody level to B. henselae was positive at 42 EIA Unit before

treatment. After treatment with intravenous cefepime and oral tosufloxacin,

his physical symptoms improved and the antibody level decreased to less

than 12 EIA Unit. EIA was very useful for diagnosis of this case. Serology

to B. henselae may replace traditional diagnostic criteria for cat scratch

disease. 

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4.) Will the real agent of cat-scratch disease please stand up? 

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Author 

Jerris RC; Regnery RL 

Address 

Emory University, Department of Pathology and Laboratory Medicine, Atlanta,

Georgia 30322, USA. 

Source 

Annu Rev Microbiol, 50():707-25 1996 

Abstract 

Cat-scratch disease has been recognized since 1889 in association with the

oculoglandular syndrome of Parinaud. The epidemiologic association with

cats was first made in 1931 and further substantiated throughout the years,

refining the interaction predominantly to kittens. Putative infectious

agents have included numerous species of bacteria, chlamydiae, and viruses.

The cultivation of Afipia spp. in the late 1980s appeared to answer the

mystery of the identity of the agent. However, even more recent analysis,

which has combined traditional microbiology, molecular methods, and

additional epidemiology, has demonstrated that Bartonella (Rochalimaea)

henselae is the definitive agent of cat-scratch disease. Our understanding

of the pathogenesis of cat-scratch disease and other diseases caused by

Bartonella species is incomplete and the spectrum of diseases continues to

emerge. We review historic and modern efforts to understand the etiology of

cat-scratch disease and related syndromes. 

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5.) [Cat scratch disease caused by Bartonella henselae] 

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Author 

S¨older B; Allerberger F; Covi B; Maurer K; Scheminzky C; Kreczy A; Sch¨on

G; Dierich MP 

Address 

Klinik f¨ur Kinder- und Jugendheilkunde, Universit¨at Innsbruck. 

Source 

Immun Infekt, 23(6):228-31 1995 Dec 

Abstract 

Bartonella henselae is an etiologic agent of cat-scratch disease and, in

immunocompromised patients, of bacillary angiomatosis and other severe

syndromes. Cat-scratch disease usually presents as lymphadenopathy, which

resolves spontaneously within 2-4 months. The utility of antibiotic therapy

remains controversial. In Tyrol four cases of human cat-scratch disease

were diagnosed in children in 1994, yielding a prevalence of 0.7/100,000

per year. A 3-year-old boy had lymphadenitis coli since one year despite

antituberculosis therapy which was initiated because of the

histopathological picture and a positive tuberculin reaction (despite

negative mycobacteria-cultures and -PCR). Two girls, age 9 and 13 years,

had lymphadenitis at upper or lower extremities after cat-scratches from

kittens. A 13-year-old boy presented with febrile illness and right hip

pain, computer tomography revealed an osteolytic lesion; symptoms subsided

within 3 weeks. Diagnosis of cat-scratch disease is based on cat contact,

negative studies for other similar diseases, characteristic histopathologic

features (if available), and results of an indirect immunofluorescence test

(antigen: Houston-1 isolate, ATCC 49882). We believe that the availability

of this serological test will increase the number of diagnosed cases of

human Bartonella henselae infections. 

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6.) Hypercalcemia due to endogenous overproduction of active vitamin D in

identical twins with cat-scratch disease. 

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Author 

Bosch X 

Address 

Internal Medicine Unit, Hospital Casa Maternitat, Corporaci´o Sanit`aria

Clinic, Barcelona, Spain. 

Source 

JAMA, 279(7):532-4 1998 Feb 18 

Abstract 

CONTEXT: The extrarenal synthesis of active vitamin D sterols has a central

causative role in the hypercalcemia associated with various granulomatous

diseases. OBJECTIVE: To study the calcium metabolism in patients with

cat-scratch disease who have hypercalcemia. DESIGN: Case report. SETTING:

University hospital in Barcelona, Spain. PATIENTS: Two identical twins who

developed asymptomatic hypercalcemia during the acute phase of cat-scratch

disease. MAIN OUTCOME MEASURES: Serial measures of calcium homeostasis and

metabolism over a 2-month period. RESULTS: On admission and 6 and 7 days

later, both patients were found to have increased levels of serum and

urinary calcium, serum phosphate, and serum 1,25-dihydroxyvitamin D

[1,25(OH)2D], whereas they had normal values of serum 25-hydroxyvitamin D

and urinary cyclic adenosine monophosphate and decreased serum

concentrations of intact parathyroid hormone. Sixteen and 20 days after

admission, these abnormalities had resolved without treatment. A direct

correlation was observed between the serum 1,25(OH)2D levels and both the

serum and 24-hour urinary calcium concentrations. Also, the concentrations

of calcium and 1,25(OH)2D paralleled the clinical activity of the

infectious disease over the period these parameters were measured.

CONCLUSIONS: Our cases provide evidence that cat-scratch disease can

produce hypercalcemia through the unregulated production of the metabolite

1,25(OH)2D. Cat-scratch disease should be added to the list of

granuloma-forming diseases that are responsible for 1,25(OH)2D-mediated

hypercalcemia. 

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7.) Cat-scratch disease caused by Bartonella henselae: the first case

report in Taiwan. 

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Author 

Lee SC; Fung CP; Lee N; Shieh WB 

Address 

Department of Pathology, Chang Gung Memorial Hospital, Keelung, Taiwan. 

Source 

J Formos Med Assoc, 97(8):569-72 1998 Aug 

Abstract 

We report a typical case of cat-scratch disease caused by Bartonella

henselae, in Taiwan. A 20-year-old man developed right axillary

lymphadenopathy 2 weeks after being scratched on his right hand by a

kitten. The axillary lymphadenopathy resolved gradually and spontaneously

after 10 weeks without specific treatment. Serologic tests were not done

during the acute stage of the event. However, an immunofluorescent antibody

test performed during the convalescent stage was positive for B. henselae

antibodies, and the concentration dropped by fourfold 2 months later.

Histopathologic examination of a biopsy specimen from the right axillary

lymph node revealed findings characteristic of cat-scratch disease

including multiple foci of microabscesses surrounded by histiocytes and

infiltration by plasma cells and lymphocytes. This is the first reported

case of cat-scratch disease in Taiwan, with a history of contact with a

cat, a positive serologic test for B. henselae infection and characteristic

histopathologic findings of cat-scratch disease which met the criteria for

diagnosis. 

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8.) [Cat-scratch disease and other infections caused by Bartonella species] 

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Author 

Schellekens JF 

Address 

Rijksinstituut voor Volksgezondheid en Milieu, Laboratorium voor

Bacteriologie en Antimicrobi¨ele Middelen, Bilthoven. 

Source 

Ned Tijdschr Geneeskd, 140(3):144-7 1996 Jan 20 

Abstract 

Bartonella henselae, the causative agent of cat-scratch disease, was

identified recently by DNA amplification techniques. Several other

Bartonellae (most of which were called Rochalimaea before) cause disease in

humans: B. bacilliformis (Carrion's disease), B. elizabethae (endocarditis)

and B. quintana (bacillary angiomatosis and peliosis, chronic bacteraemia

and endocarditis, trench fever). B. henselae is transmitted to humans by

scratch or bite of a bacteraemic, but asymptomatic, cat, which event may be

followed by regional lymphadenitis (classical cat-scratch disease),

bacillary angiomatosis or peliosis of liver and spleen (in immune

compromised, e.g. HIV-infected individuals) or chronic bacteraemia and

endocarditis (in elderly individuals). The incidence in the Netherlands of

cat-scratch disease is > 2/100,000/year. If a Bartonella infection is

suspected, specific immuno-assays and polymerase chain reaction assay may

be applied for diagnosis. Culture of the organism is difficult. Macrolides

and tetracyclines have been shown to be effective in treatment of

disseminated infections. The natural (self-limiting) course of regional

lymphadenitis however is not affected by antibiotic treatment. 

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9.) Bartonella spp. as emerging human pathogens.

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Anderson BE; Neuman MA

Department of Medical Microbiology and Immunology, College of Medicine,

University 

of South Florida, Tampa 33612, USA. banderso@com.1.med.usf.edu

Clin Microbiol Rev (UNITED STATES) Apr 1997 10 (2) p203-19 ISSN:

0893-8512

Contract/Grant No.: R29-AI38178--AI--NIAID

Language: ENGLISH

Document Type: JOURNAL ARTICLE; REVIEW; REVIEW, ACADEMIC 

Journal Announcement: 9709

Subfile: INDEX MEDICUS

Members of the genus Bartonella (formerly Rochalimaea) were virtually

unknown to 

modern-day clinicians and microbiologists until they were associated with 

opportunistic infections in AIDS patients about 6 years ago. Since that

time, 

Bartonella species have been associated with cat scratch disease, bacillary 

angiomatosis, and a variety of other disease syndromes. Clinical

presentation of 

infection with Bartonella ranges from a relatively mild lymphadenopathy

with few 

other symptoms, seen in cat scratch disease, to life-threatening systemic

disease in 

the immunocompromised patient. In some individuals, infection manifests as

lesions 

that exhibit proliferation of endothelial cells and neovascularization, a

pathogenic 

process unique to this genus of bacteria. As the spectrum of disease

attributed to 

Bartonella is further defined, the need for reliable laboratory methods to

diagnose 

infections caused by these unique organisms also increases. A brief

summary of the 

clinical presentations associated with Bartonella infections is presented,

and the 

current status of laboratory diagnosis and identification of these

organisms is 

reviewed. (205 References)

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10.) [Bartonella henselae infection in immunocompetent patients: cat

scratch disease] 

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Author 

Abarca K; Vial PA; Rivera M; Garc´ia C; Odd´o D; Prado P; Ferr´es M 

Address 

Departamentos de pediatr´ia, de Radiolog´ia y Anatom´ia Patol´ogica,

Facultad de Medicina, Pontificia Universidad Cat´olica de Chile, Santiago,

Chile. 

Source 

Rev Med Chil, 124(11):1341-9 1996 Nov 

Abstract 

BACKGROUND: Cat scratch disease, whose etiologic agent is Bartonella

henselae, is a benign disease in immunocompetent subjects, characterized by

lymphadenopathy of prolonged course and occasional involvement of other

organs such as liver, spleen, central nervous system, eye and lung. In

immunocompromised patients, the infection is bacteremic and disseminated.

AIM: To report Chilean cases of cat scratch disease. PATIENTS AND METHODS:

Ten children (seven male, aged between 6 and 13 years old) with

histologically or serologically confirmed cat scratch disease are reported.

RESULTS: Lymphadenopathy location was pre auricular in four cases, axillary

in two, inguinal in two and epitrochlear in two. Three children had fever

over 39 degrees C and two had a parinaud syndrome. Nine children had a

history of cat scratch and one of a cat byte. Six had an erythrocyte

sedimentation rate over 40. Lymph node ultrasound examination was a useful

diagnostic tool. Two patients had splenic granulomas. Lymph node biopsies

were obtained in four cases, showing a suppurative granulomatous

lymphadenitis in all and a positive Warthin-Starry stain in two. Serology,

done in patients without histological confirmation was positive with titles

ranging from 1:64 to 1:8192. All patients had a satisfactory outcome with

regression of lymphadenopathy. CONCLUSIONS: Infections by Bartonella

hemselae occur in the Chilean population and must be considered in the

differential diagnosis of regional lymph node enlargement. 

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11.) Cat-scratch disease and related clinical syndromes. 

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Author 

Smith DL 

Address 

West Jersey Family Practice Residency, Voorhees, New Jersey, USA. 

Source 

Am Fam Physician, 55(5):1783-9, 1793-4 1997 Apr 

Abstract 

Bartonella (Rochalimaea) henselae is a common cause of cat-scratch disease.

This newly identified bacterium is also the cause of several other clinical

syndromes, including bacillary angiomatosis, bacillary peliosis hepatitis

and splenitis, and acute and relapsing bacteremia. A high percentage of

young cats carry B. henselae. Fortunately, serious complications of B.

henselae infections are rare in immunocompetent patients. Cat-scratch

disease is usually a self-limited illness that does not necessarily require

antibiotic therapy. Severe or persistent cases respond well to several

antibiotics, including erythromycin and doxycycline. Cat-scratch disease

should be included in the differential diagnosis of serious neurologic

disease, particularly when regional lymphadenopathy develops suddenly in a

previously healthy patient who owns a cat. Treatment of uncomplicated

central nervous system disease is generally supportive. Antibiotic therapy

is reserved for patients with atypical or severe involvement, including

encephalopathy and retinitis. Other internal and cutaneous manifestations

of B. henselae infection have recently been described. These potentially

life-threatening infections respond well to antibiotic therapy, even in

immunocompromised patients. 

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12.) Cat-scratch disease and bacillary angiomatosis. 

=========================================================================

Author 

Chomel BB 

Address 

Department of Population Health and Reproduction, School of Veterinary

Medicine, University of California, Davis 95616, USA. 

Source 

Rev Sci Tech, 15(3):1061-73 1996 Sep 

Abstract 

Cat-scratch disease (CSD) was first described by Debr´e in 1950, yet the

causative bacterial agent of CSD remained obscure until 1992, when

Bartonella (formerly Rochalimaea) henselae was implicated in CSD by

serological and microbiological studies. B. henselae had initially been

linked to bacillary angiomatosis (BA), a vascular proliferative disease

most commonly associated with long-standing human immunodeficiency virus

(HIV) infection or other significant immunosuppression. B. henselae has

also been associated with bacillary peliosis, relapsing bacteraemia and

endocarditis in humans. Cats are healthy carriers of B. henselae, and can

be bacteraemic for months or years. It has recently been demonstrated that

B. henselae can be transmitted from cat to cat by the cat flea, but not by

direct contact between animals. The author discusses the present state of

knowledge on the aetiology, clinical features and epidemiological

characteristics of cat-scratch disease and bacillary angiomatosis. 

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13.) Detection of antibodies to Bartonella henselae in clinically diagnosed

cat scratch disease. 

=========================================================================

Author 

Flexman JP; Chen SC; Dickeson DJ; Pearman JW; Gilbert GL 

Address 

Department of Clinical Microbiology and Infectious Diseases, Royal Perth

Hospital, WA. jameflex@dunamis.rph.uwa.edu.au 

Source 

Med J Aust, 166(10):532-5 1997 May 19 

Abstract 

OBJECTIVE: To determine the usefulness of an indirect immunoflourescence

antibody test for antibodies to Bartonella henselae in diagnosing cat

scratch disease (CSD). DESIGN AND SETTING: Retrospective case survey of 354

patients whose sera were tested for antibodies to B. henselae at Royal

Perth Hospital, Perth, and the Institute of Clinical Pathology and Medical

Research, Sydney. In 1994; and measurement of the background prevalence of

antibodies to B. henselae. MAIN OUTCOME MEASURES: Prevalence of antibodies

to B. henselae, odds of a positive titre (> or = 64) in patients with and

without specific risk factors for CSD and clinical features of the disease;

prevalence of antibodies to B. henselae in randomly selected blood donors.

RESULTS: Demographic, clinical and cat contact data were available for 303

patients. Sixty-four (21.1%) had a positive titre, as did 53 of 98 (54%)

patients with a history of cat contact and lymphadenopathy. This proportion

increased to 62% (38 of 61 patients) in patients with a history of cat

scratch or bite and to 90.3% (28 of 31) in those with cat contact,

lymphadenopathy and histological evidence of granulomatous lymphadenitis.

Patients who developed lymphadenopathy after cat contact were significantly

more likely to have a positive titre than those without this history (odds

ratio [OR], 20.8; 95% confidence interval [95% Cl], 9.6-46; P < 0.0001).

Inclusion of a history of a cat scratch or bite significantly raised the

odds of being seropositive (OR, 13.7; 95% Cl, 6.8-28.1; P < 0.0001), and

the presence of granulomas on lymph node biopsy further increased the odds

(OR, 124.4; 95% Cl, 19.4-1073; P < 0.0001). The prevalence of antibodies to

B. henselae in random blood donors in New South Wales was about 5% (five of

102 sera samples). CONCLUSIONS: The immunofluorescence antibody test for B.

henselae can be expected to be positive in just over half the patients with

clinically suspected CSD, and it has a positive predictive value of 83%. In

a significant number of cases the diagnosis cannot be made on the basis of

the results of immunofluorescence antibody testing alone and further

investigations, including lymph node biopsy, may be required. 

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14.) The expanding spectrum of Bartonella infections: II. Cat-scratch disease.

=========================================================================

Bass JW; Vincent JM; Person DA

Department of Pediatrics, Tripler Army Medical Center, Honolulu, HI

96859-5000, 

USA. jamess.bass@ches.tamc.amedd.army.mil

Pediatr Infect Dis J (UNITED STATES) Feb 1997 16 (2) p163-79 ISSN:

0891-3668

Language: ENGLISH

Document Type: HISTORICAL ARTICLE; JOURNAL ARTICLE; REVIEW; REVIEW,

ACADEMIC 

Journal Announcement: 9706

Subfile: INDEX MEDICUS

Recent advancements and developments in molecular biotechnology have

allowed more 

precise reclassification of many microorganisms. With the use of these new

taxonomy 

tools, several organisms previously thought to belong to other genera have

been 

recently described as bartonellae. Of the 11 organisms now described as

Bartonella 

spp., only four have been shown to be pathogenic for humans. Table 1 lists

the four 

Bartonella human pathogens along with the their known epidemiology and the

scope and 

range of disease associated with each. All are now considered to be

bacteria and can 

be grown on blood-enriched agar although primary isolation in some may best

be 

achieved in cell tissue culture. B. bacilliformis infection is limited to

certain 

geographic regions in South America where the only human reservoir and the

sandfly 

vector(s) that spreads the disease reside together. Specific antibiotic

treatment is 

dramatically effective in treating the highly fatal, acute intraerythrocytic 

hemolytic form of the disease, but their effectiveness in treating the

vascular 

proliferative forms (verruga peruana) or the chronic asymptomatic,

bacteremic, 

carrier state of the disease has not been effective. This disease should

remain 

confined to its present endemic geographic areas in South American unless 

asymptomatic bacteremic persons from these areas migrate to areas where

sandflies and 

humans exist that are capable of establishing this infection in new endemic

areas. 

B. quintana and B. henselae cause a wide range of clinical diseases in

humans, the 

type and extent of which varies significantly with the immune status of the

host. In 

immunocompetent hosts the pathologic response is granulomatous, suppurative, 

extracellular and intracellular, generally self-limited and usually

unresponsive to 

antibiotic treatment, even to those drugs to which the organism is shown to

be 

sensitive in vitro. In contrast, in immunocompromised hosts the pathologic

response 

is vasculoproliferative, organisms may be seen intracellularly but they are

often 

seen in abundance in extracellular clumps and infection is usually

progressive and 

fatal unless treated. In these patients clinical response to treatment

with drugs 

that are effective in vitro against these organisms has usually been

dramatic. Of 

these agents those that penetrate cells and are found in high concentrations 

intracellularly, such as erythromycin, clarithromycin, azithromycin,

rifampin, 

doxycycline and gentamicin, appear to be most effective. These agents not

only 

appear to provide the most dramatic treatment response in patients with BA,

BP and 

PRFB and other manifestations of B. henselae (and B. quintana as well) in 

immunocompromised persons, they appear to be the most promising agents for

treatment 

of persons with both typical and atypical CSD. Further studies will be

necessary to 

more clearly elucidated the mechanisms responsible for the diverse clinical 

presentations of infection with these organisms in human hosts relative to

their 

immune status. In addition clarification of the epidemiology of B.

elizabethae 

infections in humans may be helpful in understanding the nature of

infection with 

Bartonella organisms. (215 References)

=========================================================================

15.) Evaluation of serological response to Bartonella henselae, Bartonella

quintana and 

Afipia felis antigens in 64 patients with suspected cat-scratch disease.

=========================================================================

Dupon M; Savin De Larclause AM; Brouqui P; Drancourt M; Raoult D; De

Mascarel A; 

Lacut JY

Service de Maladies Infectieuses et Medecine Interne, Hopital Pellegrin,

France.

Scand J Infect Dis (SWEDEN) 1996 28 (4) p361-6 ISSN: 0036-5548

Language: ENGLISH

Document Type: JOURNAL ARTICLE 

Journal Announcement: 9704

Subfile: INDEX MEDICUS

The serological response to Bartonella henselae, B. quintana, and Afipia

felis was 

assessed by an indirect fluorescence antibody test (IFAT) in 64 patients with 

suspected cat-scratch disease (CSD) recruited from the Bordeaux area in

France. 

Blood samples were collected from 57 patients with chronic lymphadenopathy

who 

underwent lymph-node biopsy with suggestive histopathologic features of

CSD, and from 

an additional 7 patients with suspected CSD who underwent surgical incision

and 

drainage because of lymph-node tenderness. Of the patients, 31 were male

and 33 

female, with a median age of 27 years (range 2-89). 69.8% reported cat

and/or dog 

contact. Of the 26/64 (40.6%) patients, serum samples were positive at a

titer of 

1:100 or more for immunoglobulin G (IgG) antibodies (17 only to B.

henselae, 1 only 

to B. quintana, 3 only to Afipia felis, and 5 to both B. henselae and B.

quintana). 

IgM or IgA antibodies were also detected in 10 patients with IgG antibodies

to B. 

henselae. 11 (17.2%) of the 64 patient serum samples were positive at a

low titer of 

1:50. These data suggested that serological response assessed by standard

IFAT is 

not enough to confirm a CSD diagnosis.

=========================================================================

16.) [Cat scratch disease and associated infections] 

=========================================================================

Author 

Chomel BB; Boulouis HJ; Gurfield AN; Heller R; Pi´emont Y; Pilet C 

Address 

Department of Population Health and Reproduction, School of Veterinary

Medicine, University of California, Davis, USA. 

Source 

Bull Acad Natl Med, 181(3):441-50; discussion 451-4 1997 Mar 18 

Abstract 

Cat scratch disease (CSD) was first described in France by Debr´e et al. in

1950, yet the causative bacterial agent of CSD remained obscure until 1992,

when Bartonella (formerly Rochalimaea) henselae was implicated in CSD by

serological and microbiologic studies. B. henselae had been linked

initially to bacillary angiomatosis (BA), but also bacillary peliosis,

relapsing bacteremia and endocarditis. Cats are healthy carriers of B.

henselae and B. clarridgeiae, and can be bacteremic for months to years.

Cat to cat transmission of the organism involves the cat flea in absence of

direct contact transmission. Present knowledge on the etiology, clinical

features and epidemiological characteristics of cat scratch

disease/bacillary angiomatosis are presented. 

=========================================================================

17.) Cat-scratch disease simulating Histiocytosis X. 

=========================================================================

Author 

Berg LC; Norelle A; Morgan WA; Washa DM 

Address 

Department of Pathology, Gunderson Clinic, Ltd, LaCrosse, WI 45601, USA. 

Source 

Hum Pathol, 29(6):649-51 1998 Jun 

Abstract 

Cat-scratch disease is a self-limited condition commonly causing a benign

chronic lymphadenopathy in children. Osteolytic lesions are a rare

complication, but have been previously reported. We report a case of a

solitary osteolytic lesion of the skull whose clinical, radiographic and

pathological features were initially interpreted as being consistent with

Histiocytosis X. Subsequently, positive serological titers for Bartonella,

a history of a cat-scratch antecedent to the onset of clinical symptoms and

review of the original histopathology confirmed the diagnosis of

cat-scratch disease. We reviewed the English language literature on

osteolytic lesions associated with cat-scratch disease and compare the

current case with those previously reported. 

=========================================================================

18.) [Atypical cat-scratch disease: a case report of splenic granulomatosis] 

=========================================================================

Author 

Dodi I; Iughetti L; Nasi S; Rossi C; Caselli G; Malvicini R 

Address 

Divisione di Pediatria, Ospedale Civile di Fidenza PR, Italia. 

Source 

Pediatr Med Chir, 19(2):143-4 1997 Mar-Apr 

Abstract 

Generally cat-scratch disease is a benign inflammatory adenopathy. The

Authors describe an atypical form of this disease, characterized by

persistent fever and splenic granulomatosis requiring a diagnostic and

therapeutic prolonged effort. They point out the important role of new

immuno-fluorescent techniques to exactly identify the bacterium--Bartonella

henselae--causing cat-scratch disease and suggest to include cat-scratch

disease among the causes of unknown origin fever. 

=========================================================================

19.) [2 patients with atypical manifestations of cat-scratch disease]

Twee patienten met atypische manifestaties van kattenkrabziekte.

=========================================================================

Kusumanto YH; Veenhoven RH; Bokma JA; Schellekens JF

Spaarne Ziekenhuis, afd. Kindergeneeskunde, Haarlem.

Ned Tijdschr Geneeskd (NETHERLANDS) Feb 22 1997 141 (8) p385-7 ISSN:

0028-2162

Language: DUTCH Summary Language: ENGLISH

Document Type: 

JOURNAL ARTICLE English Abstract

Journal Announcement: 9707

Subfile: INDEX MEDICUS

In 2 boys aged 8 years and 10 months, respectively, uncommon

manifestations of cat 

scratch disease were seen. The first patient had acute encephalopathy:

coma and 

generalized tonic-clinic convulsions. The second patient was presented

with fever 

and peripheral lymphadenopathy in combination with hypodense lesions in the

liver on 

ultrasound. Diagnosis was established on the clinical picture and the

positive 

results of serological testing of antibody titres for Bartonella henselae.

Both 

patients recovered completely within 2 months.

=========================================================================

20.) [Visceral localizations of cat-scratch disease in an immunocompetent

patient] 

=========================================================================

Author 

Bouchard O; Bosseray A; Leclercq P; Micoud M 

Address 

H^opital Michallon, CHU de Grenoble. 

Source 

Presse Med, 25(5):199-201 1996 Feb 10 

Abstract 

Locoregional expression of cat scratch disease is well known, but despite

advances in microbiology over the last 10 years leading to the description

of two new bacteria (Afipia felis, Bartonella henselae) the infective agent

responsible for cat scratch syndrome remains unknown. Until the 80s, only

one systemic disease was attributed to infection with a germ in the

Bartonella genus: trench fever. With the onset of the AIDS epidemic, new

clinical syndromes caused by Bartonella bacteria have been described:

bacillary angiomatosis, hepatic peliosis, cases of recurrent septicemia,

cases of endocarditis, etc. More recently, atypical forms of cat scratch

disease including systemic diseases have been reported in immunocompetent

subjects. Although quite rare (1% of the cases), such types of expression

can raise questions as to diagnosis both in terms of clinical signs and in

terms of bacteriological findings. Clinical and experimental data do not

provide a clear direction for treatment but would suggest that prolonged

use of aminoglycosides is useful. 

=========================================================================

21.) Serous retinal detachment of the macula associated with cat scratch

disease. 

=========================================================================

Author 

Zacchei AC; Newman NJ; Sternberg P 

Address 

Department of Ophthalmology, Emory University School of Medicine, New York,

New York, USA. 

Source 

Am J Ophthalmol, 120(6):796-7 1995 Dec 

Abstract 

PURPOSE: We studied an unusual ocular manifestation of cat scratch disease.

METHODS: We examined a patient who had a serous retinal detachment of the

macula with vision loss out of proportion to her retinal findings. RESULTS:

The patient was found to have cat scratch disease by antibody titers.

CONCLUSION: Cat scratch disease should be considered in patients with a

serous neurosensory retinal detachment of the macula and a history of cat

exposure or systemic signs or symptoms consistent with the disease. 

=========================================================================

22.) Cat scratch disease in Greece. 

=========================================================================

Author 

Karpathios T; Golphinos C; Psychou P; Garoufi A; Papadimitriou A;

Nicolaidou P 

Address 

Second Department of Paediatrics, P and A Kyriakou Children's Hospital,

Athens, Greece. 

Source 

Arch Dis Child, 78(1):64-6 1998 Jan 

Abstract 

An indirect fluorescent antibody test for Bartonella henselae, B quintana,

and B elizabethae was performed in all 18 children who presented to our

paediatric outpatient clinic with cat scratch disease over a six year

period. Serum samples were taken on admission, after 15 days, and after six

months. Diagnosis was confirmed in 15 patients (83%) and was based on

seroconversion or a fourfold change of the antibody titre to B henselae in

12 patients and on a single high titre (> 128) in three patients.

Lymphadenopathy was present in all patients, erythema nodosum in one,

osteomyelitis in one, hepatitis in one, transverse myelitis in one, and

liver or spleen granulomata, or both, in three patients. Cat scratch

disease developed in autumn or winter in 12 patients. All had a history of

physical contact with a cat. Our study shows that our clinical suspicion

was accurate in the diagnosis of cat scratch disease in a high percentage

of patients presenting to a hospital and that indirect fluorescent antibody

testing for B henselae is a useful diagnostic tool. 

=========================================================================

23.) Cat-scratch disease--an overlooked disease in Denmark?]

=========================================================================

Kattekradssygdom--en overset sygdom i Danmark?

Blomgren M; Hardt-Madsen M

Organkirurgisk afdeling K, Sygehus Fyn.

Ugeskr Laeger (DENMARK) May 5 1997 159 (19) p2876-7 ISSN: 0041-5782

Language: DANISH Summary Language: ENGLISH

Document Type: 

JOURNAL ARTICLE English Abstract

Journal Announcement: 9708

Subfile: INDEX MEDICUS

Only one patient with cat-scratch disease (CSD) has been reported in

Denmark. A 

case and retrospective investigation among patients admitted to the ward is

presented. 

Over a period of 3.5 years, six patients were found to have suffered from

CSD. The 

yearly incidence was calculated to 2.6/100,000. The patients were tested for 

antibodies against Bartonella (Rochalimaea) henselae with a new test

developed at the 

Danish Serum Institute. Only two of the patients with CSD had titres of

antibodies 

higher than 400 (positive). Tested again with an improved test five of the

six 

patients were found to have antibodies against B. henselae. It is assumed

that CSD 

is found with the same incidence as the USA and Holland. It is recommended

that 

examination for chronic lymphadenopathy includes questions about cat

contact and 

testing for antibodies against Bartonella henselae.

=========================================================================

24.) Prolonged Bartonella bacteremia in cats associated with cat-scratch

disease patients. 

=========================================================================

Author 

Kordick DL; Wilson KH; Sexton DJ; Hadfield TL; Berkhoff HA; Breitschwerdt EB 

Address 

Department of Companion Animal and Special Species Medicine, College of

Veterinary Medicine, North Carolina State University, Raleigh 27606, USA. 

Source 

J Clin Microbiol, 33(12):3245-51 1995 Dec 

Abstract 

Recent evidence supports a causal relationship between Bartonella

(Rochalimaea) henselae, cat-scratch disease (CSD), and bacillary

angiomatosis. Cats appear to be the primary reservoir. Blood from 19 cats

owned by 14 patients diagnosed with CSD was cultured. Blood samples from

cats owned by veterinary students (n = 25) having no association with CSD

or bacillary angiomatosis were cultured as controls. Eighty-nine percent

(17 of 19) of cats associated with CSD patients and 28% (7 of 25) of

controls were bacteremic with Bartonella species (chi-square = 16.47; P <

0.001). Twenty-three isolates were characterized as B. henselae, while one

isolate from the cat of a CSD patient appeared to be a new Bartonella

species. Thirteen cats remained culture positive during the ensuing

12-month period. Our results support the conclusion that B. henselae is the

predominant species involved in CSD and is transmitted by cats. The

incidence of Bartonella bacteremia in control cats suggests that B.

henselae bacteremia is prevalent among the domestic cat population in the

United States. 

=========================================================================

25.) Application of polymerase chain reaction assay in the diagnosis of

orbital granuloma complicating atypical oculoglandular cat scratch disease. 

=========================================================================

Author 

Dondey JC; Sullivan TJ; Robson JM; Gatto J 

Address 

Oculoplastics Clinic, Department of Ophthalmology, Royal Brisbane Hospital,

Herston, Australia. 

Source 

Ophthalmology, 104(7):1174-8 1997 Jul 

Abstract 

BACKGROUND: Parinaud oculoglandular syndrome is uncommon. Most cases are

caused by cat scratch disease (CSD), recently discovered to be associated

with the pathogen Bartonella henselae. Before isolation of the

micro-organism, diagnosis relied on the presence of characteristic clinical

features. However, atypical cases could cause diagnostic problems. With the

development of an indirect fluorescent antibody test and polymerase chain

reaction (PCR) assay, oculoglandular CSD can be diagnosed readily. METHODS:

The authors report a case of atypical Parinaud oculoglandular syndrome in a

51-year-old woman who presented with an inferior conjunctival forniceal

mass extending into anterior orbital tissues. Blood and operative tissue

specimens were obtained for routine screening and histopathologic analysis

but more specifically for serologic analysis, culture, and PCR assay for B.

henselae. Computed tomography was performed to delineate the mass. RESULTS:

Cultures for B. henselae were negative. Initial serologic analysis

demonstrated a low IgG response without detectable IgM, but 1 month later

had undergone a fourfold rise in IgG, again without detectable IgM.

Histopathologic analysis showed a nonspecific necrotizing granulomatous

inflammation consistent with but not diagnostic of CSD. Polymerase chain

reaction assay for B. henselae was strongly positive. Computed tomographic

scan showed a preseptal and anterior orbital inflammatory process.

CONCLUSIONS: Cat scratch disease due to B. henselae should be suspected in

patients with atypical conjunctival inflammation associated with regional

lymphadenopathy. PCR assay is extremely useful in establishing the

diagnosis. The PCR assay offers the additional advantage of early diagnosis

because the test is positive early in the disease. Antibiotic therapy

remains controversial. In this case, surgical excision hastened resolution

of the conjunctival inflammation. However, the lymphadenopathy responded

poorly to antibiotics. 

=========================================================================

26.) Systemic cat scratch disease: hepatic and splenic involvement about 3

pediatric cases. 

=========================================================================

Author 

Destuynder O; Vanlemmans P; Mboyo A; Destuynder R; Aubert D; DeBilly B;

Colin P; Leroy J; Estavoyer JM; Viennet G 

Address 

Department of Pediatric Surgery, Saint-Jacques Hospital Besan¸con, France. 

Source 

Eur J Pediatr Surg, 5(6):365-8 1995 Dec 

Abstract 

Numerous diseases can lead to multinodular lesions of liver and spleen;

surgical biopsy can be required for the etiologic diagnosis. Among these

diseases, systemic cat scratch disease has been recently described.

Macroscopical appearance of the lesions is evocative and must be known by

surgeons. Three children with systemic cat scratch disease involving liver

and spleen are reported. 

Language 

=========================================================================

27.) Bartonella clarridgeiae, a newly recognized zoonotic pathogen causing

inoculation papules, fever, and lymphadenopathy (cat scratch disease). 

=========================================================================

Author 

Kordick DL; Hilyard EJ; Hadfield TL; Wilson KH; Steigerwalt AG; Brenner DJ;

Breitschwerdt EB 

Address 

Department of Companion Animal and Special Species Medicine, College of

Veterinary Medicine, North Carolina State University, Raleigh 27606, USA. 

Source 

J Clin Microbiol, 35(7):1813-8 1997 Jul 

Abstract 

Shortly after adopting a 6-week-old cat, a veterinarian was bitten on the

left index finger. Within 3 weeks, he developed headache, fever, and left

axillary lymphadenopathy. Initial blood cultures from the cat and

veterinarian were sterile. Repeat cultures from the cat grew

Bartonella-like organisms with lophotrichous flagella. Sera from the

veterinarian were not reactive against Bartonella henselae, B. quintana, or

B. elizabethae antigens but were seroreactive (reciprocal titer, 1,024)

against the feline isolate. Sequential serum samples from the cat were

reactive against antigens of B. henselae (titer, 1,024), B. quintana

(titer, 128), and the feline isolate (titer, 2,048). Phenotypic and

genotypic characterization of this and six additional feline isolates,

including microscopic evaluation, biochemical analysis, 16S rRNA gene

sequencing, DNA-DNA hybridization, and PCR-restriction fragment length

polymorphism of the 16S gene, 16S-23S intergenic spacer region, and citrate

synthase gene identified the isolates as B. clarridgeiae. This is the first

report of cat scratch disease associated with B. clarridgeiae. 

=========================================================================

28.) Coinfection with Bartonella clarridgeiae and Bartonella henselae and

with different Bartonella henselae strains in domestic cats.

=========================================================================

Gurfield AN; Boulouis HJ; Chomel BB; Heller R; Kasten RW; Yamamoto K;

Piemont Y

Department of Population Health and Reproduction, School of Veterinary

Medicine, 

University of California, Davis, 95616, USA.

J Clin Microbiol (UNITED STATES) Aug 1997 35 (8) p2120-3 ISSN: 0095-1137

Language: ENGLISH

Document Type: JOURNAL ARTICLE 

Journal Announcement: 9711

Subfile: INDEX MEDICUS

Bartonella clarridgeiae and several strains of Bartonella henselae, the

agent of 

cat scratch disease, with variations in the 16S rRNA gene have been found

to infect 

the blood of cats. An epidemiologic study of Bartonella infection in

domestic French 

cats revealed that of 436 cats sampled, 5 cats (1.1%) were coinfected with B. 

henselae and B. clarridgeiae and 2 cats (0.5%) were coinfected with two

strains of B. 

henselae with variations in the 16S rRNA gene, B. henselae type I and type

II. In an 

indirect immunofluorescence assay, coinfected cats tested positive for both 

Bartonella species at titers of > or = 128. Identification of the colonies

was 

achieved by preformed enzyme analysis, PCR-restriction fragment length

polymorphism 

analysis of the citrate synthase gene, and 16S rRNA gene sequencing.

Colony size 

differences in mixed culture allowed differentiation of the Bartonella

species. The 

coinfection of cats with two Bartonella species or variants of the same

species 

raises concern about the possibility of dual infection in humans. The

development of 

a polyvalent vaccine targeted against the most pathogenic or invasive

strains may be 

a means of protecting cats and man from infection.

=========================================================================

29.) [Cat-scratch disease: historical, clinical, phylogenetic and taxonomic

aspects]

Katzenkratzkrankheit: historische, klinische, phylogenetische und

taxonomische 

Aspekte.

=========================================================================

Muller HE

Tierarztl Prax (GERMANY) Apr 1997 25 (2) p94-9 ISSN: 0303-6286

Language: GERMAN Summary Language: ENGLISH

Document Type: 

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL English Abstract

Journal Announcement: 9708

Subfile: INDEX MEDICUS

The cat-scratch disease (CSD) is known as a nosological entity since

1950. It was 

diagnosed by the clinical symptoms, epidemiologic data, and the

intracutaneous test 

of Hanger and Rose. The aetiologic agent is Bartonella (formerly

Rochalimaea) 

henselae occurring in thirty to fifty percent of healthy cats. The

gramnegative 

alpha-2-proteobacteria cause the CSD but also fever in healthy humans.

Patients 

suffering from AIDS show bacillary angiomatosis, bacillary peliosis hepatis, 

endocarditis, and septicemia. There is an open question for other

aetiologic agents 

causing CSD as cofactors. For example, Afipia felis is found to a certain

extent 

from patients suffering from CSD. Furthermore, Rothia dentocariosa was

isolated in 

lymphnodes of CSD patients, and also other grampositive rods may play an

important 

role together with B. henselae in CSD. (30 References)

=========================================================================

30.) Molecular diagnosis of cat scratch disease: a two-step approach.

=========================================================================

Avidor B; Kletter Y; Abulafia S; Golan Y; Ephros M; Giladi M

The Bernard Pridan Laboratory for Molecular Biology of Infectious

Diseases, Ichilov 

Hospital, Tel-Aviv Sourasky Medical Center, Israel.

J Clin Microbiol (UNITED STATES) Aug 1997 35 (8) p1924-30 ISSN:

0095-1137

Language: ENGLISH

Document Type: JOURNAL ARTICLE 

Journal Announcement: 9711

Subfile: INDEX MEDICUS

Amplification of Bartonella henselae DNA has been proposed as a

diagnostic test for 

cat scratch disease (CSD). The sensitivities of the following three PCR

assays were 

compared. PCR/rRNA with universal primers amplifies part of the 16S rRNA

gene, 

followed by hybridization with a specific B. henselae probe; PCR/CS and

PCR/HSP 

amplify portions of the gltA and the htrA genes, respectively, each

followed by 

restriction fragment length polymorphism analysis. The threshold of

detection of B. 

henselae DNA in pus was 10(-4), 10(-3), and 10(-2) ng for PCR/rRNA, PCR/CS,

and 

PCR/HSP, respectively. By these three assays, B. henselae DNA was detected

in 100, 

94, and 69% of 32 pus and lymph node specimens from CSD patients,

respectively. The 

similar sensitivities of the PCR/rRNA and the PCR/CS assays for detecting

B. henselae 

DNA in clinical specimens are in contrast to the 10-fold difference in

sensitivities 

in favor of PCR/rRNA demonstrated with purified B. henselae DNA in sterile

pus, 

suggesting that in the majority of cases, the bacterial load in clinical

specimens is 

large enough to be identified by the PCR/CS assay. A two-step approach is

suggested 

to achieve maximal sensitivity for detecting B. henselae in clinical

specimens: 

initial testing by PCR/CS (which does not require hybridization), followed by 

PCR/rRNA with PCR/CS-negative specimens when CSD is strongly suspected.

=========================================================================

31.) Antibiotic therapy for cat-scratch disease: clinical study of

therapeutic outcome in 268 patients and a review of the literature.

=========================================================================

Author(s) Margileth AM

Address Department of Pediatrics, University of Virginia Health Sciences

Center, Charlottesville.

Source Pediatr Infect Dis J 1992;11:474.

Abstract 

During 24 months in an uncontrolled, retrospective study of 268 patients

with cat-scratch disease (CSD), 202 were treated with 18 different

antimicrobial agents. Criteria for antibiotic effectiveness were

established. One or two antibiotics were taken separately for at least 3 to

5 days by 202 patients with CSD. Outcome was determined by follow-up

examinations and telephone. Effectiveness of antibiotic therapy was based

upon 3 or more days of therapy and clinical improvement of the patient with

absence of and/or a decrease in malaise, fatigue, fever, headache,

anorexia, lymphadenopathy and, in 90 patients, a declining or normal

sedimentation rate. Of 18 different antimicrobials prescribed, 14 commonly

used antibiotics were judged to be of little or no value in treatment of

CSD. Four antimicrobials were efficacious. Efficacy of the three oral drugs

in decreasing order was: rifampin 87%, ciprofloxacin 84%,

trimethoprim-sulfamethoxazole 58%. Gentamicin sulfate intramuscular was 73%

effective. Antibiotic therapy can be considered for patients with severe

cat scratch disease. Conservative, symptomatic treatment is recommended for

the majority of patients with mild or moderate CSD.

=========================================================================

32.) Successful treatment of cat-scratch disease with ciprofloxacin [see

comments]

=========================================================================

Author(s) Holley HP Jr

Address Division of Infectious Diseases, Medical University of South

Carolina, Charleston 29425.

Source JAMA 1991;265:1563 - 5.

Abstract 

Cat-scratch disease is usually a benign, self-limited disease. Infection

may be asymptomatic but is commonly associated with painful regional

lymphadenitis. Occasionally, disease may result in systemic symptoms and

dissemination. Five adult patients, aged 24 to 57 years, were diagnosed as

having cat-scratch disease, based on a positive history of cat scratches

followed by typical symptoms including painful regional lymphadenitis,

malaise, and positive cat-scratch skin tests. Diagnostic evaluations

revealed no other cause for the lymphadenitis. Three patients had not

received prior treatment with antibiotics, and two patients had failed to

improve on other antibiotics. All five were treated with oral

ciprofloxacin, 500 mg by mouth, twice daily. All patients had dramatic

improvement in symptoms within a few days and none has relapsed during

follow-up. This is the first report of successful treatment of cat-scratch

disease with ciprofloxacin, which appears to be an effective therapy for

cat-scratch disease in adults.

=====================================================================

DATA-MÉDICOS/DERMAGIC-EXPRESS No (44) 11/03/99 DR. JOSE LAPENTA R. 

======================================================================

Produced by Dr. José Lapenta R. Dermatologist

Venezuela 1.998-2.024

Producido por Dr. José Lapenta R. Dermatólogo
Venezuela 1.998-2.024

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