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ARTICLE

Syndrome of Rochalimaea henselae Adenitis Suggesting Cat Scratch Disease

Matthew J. Dolan; Michael T. Wong; Russell L. Regnery; James H. Jorgensen; Maria Garcia; John Peters; and Dennis Drehner

1 March 1993 | Volume 118 Issue 5 | Pages 331-336

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.

Author and Article Information

From Wilford Hall USAF Medical Center, Lackland AFB, Texas; the Centers for Disease Control, Atlanta, Georgia; the University of Texas Health Science Center, San Antonio, Texas.
Requests for Reprints: Matthew J. Dolan, MD, Department of Infectious Diseases, Wilford Hall USAF Medical Center, Lackland AFB, TX 78236.
Acknowledgments: The authors thank Dr. Theodore E. Woodward and Dr. Gregory P. Melcher for review of the manuscript.

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Annals 1993 118: 363-365. [ABSTRACT][Full Text]  

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