Syndrome of Rochalimaea henselae adenitis suggesting cat scratch disease

M. J. Dolan, M. T. Wong, R. L. Regnery, J. H. Jorgensen, M. Garcia, J. Peters, D. Drehner

Research output: Contribution to journalArticlepeer-review

270 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)331-336
Number of pages6
JournalAnnals of internal medicine
Volume118
Issue number5
DOIs
StatePublished - Jan 1 1993

Keywords

  • Afipia felis
  • Cat-scratch disease
  • Lymphadenitis
  • Rochalimaea henselae

ASJC Scopus subject areas

  • Internal Medicine

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