Re: Cat scratch

Hello:

The information does make sense with some knowledge provided. Here's a little bit more on Cat Scratch Disease.


http://arjournals.annualreviews.org/doi/abs/10.1146/annurev.med.47.1.355


Abstract
Annual Review of Medicine
Vol. 47: 355-364 (Volume publication date February 1996)
(doi:10.1146/annurev.med.47.1.355)
BARTONELLA (ROCHALIMAEA) INFECTIONS: Beyond Cat Scratch

W. Schwartzman, M.D. ­
Department of Medicine and Section of Infectious Diseases, Sepulveda VA Medical Center, Sepulveda, California 91343

▪ Abstract Five species of Bartonella have been found to infect humans, henselae, quintana, elizabethae, bacilliformis, and vinsonii. The most common of these in North America are Bartonella quintana and Bartonella henselae, the agents of trench fever, bacillary angiomatosis, and parenchymal peliosis, and in the case of B. henselae cat-scratch disease. B. bacilliformisis endemic in Peru and Ecuador, where it causes oroya fever or Carrion's disease. New methods of diagnosing Bartonella infections have resulted in increased recognition of the many manifestations of these infections. Early recognition is crucial, as these are potentially fatal opportunistic infections that usually respond rapidly to appropriate antimicrobial therapy.




http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=172893

Clinical Microbiology Reviews
Clin Microbiol Rev. 1996 July; 9(3): 273–292.

M Maurin and D Raoult
Bartonella (Rochalimaea) quintana infections.

Abstract

Bartonella (formerly Rochalimaea) quintana is the etiological agent of trench fever, a disease extensively reported during the World Wars. Recent molecular biology approaches have allowed dramatic extension of the spectrum of Bartonella infections. B. quintana is now also recognized as an etiological agent of fever and bacteremia, endocarditis, bacillary angiomatosis, and chronic lymphadenopathy. Human immunodeficiency virus-infected patients and/or homeless people are the most vulnerable to infection. Poverty and louse infestation were the main epidemiological factors associated with B. quintana infections during wartime. Although poverty and chronic alcoholism have been associated with modern cases of trench fever and bacteremia due to B. quintana in Europe and the United States, vectors for B. quintana have not been clearly identified and B. quintana has not been isolated from modern-day lice. Microscopic bacillary angiomatosis lesions are characterized by tumor-like capillary lobules, with proliferating endothelial cells. In vitro experiments have shown that B. quintana survives within endothelial cells and stimulates cell proliferation. These observations, together with the finding that lesions may regress when antibiotic therapy is administered, strongly suggest that B. quintana itself stimulates angiogenesis. Bartonella infections are characterized by a high frequency of relapses after brief courses of antibiotic therapy. It is to be noted that in vitro, although Bartonella species are highly susceptible to antibiotics, only the aminoglycosides have proved to be bactericidal. However, the most effective antibiotic regimen for Bartonella infections remains to be established.


Here's where misdiagnosis occurred (translated from Chinese text):


http://translate.google.com/translate?hl=en&sl=zh-CN&u=http://scholar.ilib.cn...

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Clinical Analysis of the 8 Cases of Cat-scratch disease
7/2005

Objective To investigate the clinical characteristics of cat-scratch disease and treatment. Methods A retrospective analysis of our hospital, 1995-2004, eight cases of cat-scratch disease. Misdiagnosed as the result of one case of occult breast cancer, lymph node the two cases, two cases of lymphoma, multiple nerve schwannomas one cases, one case of chronic lymphadenitis, are mass excision, such as anti-inflammatory treatment to recover. conclusions of cat-scratch disease without clinical features of the performance, easily misdiagnosed, and a typical cat-scratch disease in discovering the bite site of a small lesions, Later regional lymph nodes, and features a micro abscess granuloma formation; Warthin-Starry silver staining showed bacteria, surgery and drug therapy, results were very good.

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