Culture-Proved Disseminated Cat-Scratch Disease in Acquired Immunodeficiency Syndrome

Hepatic bacillary angiomatosis in a patient with AIDS

“…Both organisms are small, 0.2-0.3 txm, pleomorphic bacilli that are nicely stained by the Warthin-Starry technique but are notably not acid-fast [5]. The BA organism has been recovered in culture from cutaneous lesions, blood, pleural fluid, and liver aspirate, and additionally identified on staining in spleen, bone marrow, lymph nodes, and duodenum [5,[8][9][10]. Both on initial staining and in culture, the organism resembled that isolated from patients with classic cat scratch disease.…”

“…In a second case of histopathologically proven hepatic and splenic BA, CT showed mild hepatic enlargement and moderate splenomegaly with multiple splenic "target" lesions or areas of low attenuation with surrounding enhancement. Schlossberg et al [9] report an additional case of a patient with necrotizing lymphadenitis and radiographic evidence of hepatic abscesses, in whom pleural fluid and liver aspirate yielded characteristic BA bacilli. Interestingly, although classic cat scratch disease is usually a self-limited illness, systemic disease including the finding of multiple hepatic abscesses has also been reported [12].…”

Cat-Scratch Disease Associated with Pleural Effusions and Encephalopathy in a Child

“…The disease is generally mild in symptomatology, although many systemic complications have been de scribed. A review of the literature revealed 3 cases of pleu ral effusions in patients with cat-scratch disease [1][2][3]. We present a case involving an 11-year-old child with bilater al pleural effusions and acute encephalopathy associated with cat-scratch disease.…”

“…A small gram-negative bacillus in lymph nodes of infected patients was first identified in 1988 with the use of the Warthin-Starry stain [6], Intradermal skin test ing has been available for over 40 years using purified material obtained from involved lymph nodes [7], Al though for some time Afipia felis was felt to be the incrim inating pathogen, recent evidence suggests that Rochalimaea henselae may play a primary etiologic role [8], Cur rently, the role of this pathogen remains controversial. Unusual manifestations of this disease have been re ported, including oculoglandular syndrome [9], hepatitis [1,2,10,11], erythema nodosum, and other unusual skin lesions [12,13], osteolytic bone lesions [14], pneumonia [15] and various neurological syndromes [16][17][18][19]. In 1986.…”

“…Similarly. Schlossberget al [2], in 1989, reported diffuse systemic involve ment in an adult patient with human immunodeficiency virus infection who had pleural effusions and hepatic dys function. Most recently, a 6.5-year-old girl who presented to medical attention with status epilepticus, encephalopa thy, erythematous rash, pharyngitis and cervical lymphadenopathy ultimately was diagnosed with cat-scratch disease.…”