title: Neuroretinitis, aseptic meningitis, and lymphadenitis associated with Bartonella (Rochalimaea) henselae infection in immunocompetent patients and patients infected with human immunodeficiency virus type 1.
abstract: Bartonella (Rochalimaea) henselae causes a variety of diseases, including bacillary angiomatosis, peliosis hepatis, lymphadenitis, aseptic meningitis with bacteremia, and cat-scratch disease (CSD). Cases of B. henselae-related disease were collected from September 1991 through November 1993. Patients with suspected CSD, unexplained fever and lymphadenitis, or suspected B. henselae infection who were seen in the Infectious Diseases Clinic at Wilford Hall Medical Center (Lackland Air Force Base, TX) underwent physical and laboratory examinations. In addition to three previously described cases, 23 patients with R. henselae-related infection were identified. The patients included 19 immunocompetent individuals presenting with lymphadenitis (11), stellate neuroretinitis (5), Parinaud's oculoglandular syndrome with retinitis (1), chronic fatigue syndrome-like disease (1), and microbiologically proven adenitis without the presence of immunofluorescent antibodies to B. henselae (1) and four patients infected with human immunodeficiency virus type 1 presenting with isolated lymphadenitis (1), diffuse upper-extremity adenitis (1), neuroretinitis (1), and aseptic meningitis (1). A couple with neuroretinitis and their pet cat, a persistently fatigued patient, and a patient with Parinaud's oculoglandular syndrome were shown to have bacteremia. Tissue cultures were positive for B. henselae in three recent cases of adenitis. Twenty-two patients were exposed to cats. This series further demonstrates the similarities between B. henselae-related diseases and CSD and identifies several new syndromes due to B. henselae.
authors.affiliation: Department of Infectious Diseases/PSMI, Wilford Hall Medical Center, Lackland Air Force Base, Texas 78236-5300, USA.
authors.forename: M T
authors.initials: MT
authors.lastname: Wong
authors.forename: M J
authors.initials: MJ
authors.lastname: Dolan
authors.forename: C P
authors.initials: CP
authors.lastname: Lattuada
authors.forename: R L
authors.initials: RL
authors.lastname: Regnery
authors.forename: M L
authors.initials: ML
authors.lastname: Garcia
authors.forename: E C
authors.initials: EC
authors.lastname: Mokulis
authors.forename: R A
authors.initials: RA
authors.lastname: LaBarre
authors.forename: D P
authors.initials: DP
authors.lastname: Ascher
authors.forename: J A
authors.initials: JA
authors.lastname: Delmar
authors.forename: J W
authors.initials: JW
authors.lastname: Kelly
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology / Q000662:veterinary; D018416:Bartonella henselae / Q000302:isolation & purification*; D002371:Cat Diseases / Q000188:drug therapy / Q000382:microbiology; D002372:Cat-Scratch Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000662:veterinary; D002415:Cats; D002648:Child; D002675:Child, Preschool; D005260:Female; D005654:Fundus Oculi; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D006801:Humans; D007121:Immunocompetence; D008199:Lymphadenitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D008582:Meningitis, Aseptic / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008875:Middle Aged; D009902:Optic Neuritis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D012173:Retinitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents