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Cat scratch disease: a bacterial infection.

D J Wear, A M Margileth, T L Hadfield

    Science (New York, N.Y.)
    |September 30, 1983
    PubMed
    Summary
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    Researchers identified delicate, pleomorphic Gram-negative bacilli in lymph nodes of patients with cat scratch disease (CSD). These findings strongly suggest these bacteria are the cause of CSD.

    Area of Science:

    • Microbiology
    • Pathology
    • Immunology

    Background:

    • Cat scratch disease (CSD) is a common bacterial infection.
    • The causative agent of CSD has been elusive.
    • Diagnosis often relies on clinical presentation and lymph node biopsy.

    Purpose of the Study:

    • To identify the causative agent of cat scratch disease.
    • To characterize the morphology and staining properties of the suspected pathogen.
    • To differentiate the pathogen from other related bacteria.

    Main Methods:

    • Histopathologic examination of lymph node biopsies from 39 CSD patients.
    • Warthin-Starry silver impregnation stain for visualizing bacteria.
    • Immunoperoxidase staining with patient convalescent serum and control sera (Legionella, Rickettsia).

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    Main Results:

    • Delicate, pleomorphic Gram-negative bacilli were detected in 34 of 39 lymph nodes.
    • Organisms were located within capillary walls and microabscesses.
    • The bacilli stained effectively with Warthin-Starry and immunoperoxidase methods using patient serum.
    • No cross-reactivity was observed with sera against Legionella pneumophila or Rickettsia species.

    Conclusions:

    • The identified bacilli are the likely causative agents of cat scratch disease.
    • This finding aids in understanding CSD pathogenesis.
    • The study provides histopathologic evidence for diagnosing CSD.