[Cat scratch disease. Bartonella henselae antibodies and DNA detection in regional lymphadenopathy].
METHODS
Two hard, pressure-sensitive nodules developed in the lower jaw of a 22-year-old woman. After a dental cause had been excluded, she was treated for suspected tonsillitis with Ceftibuten. Erythrocyte sedimentation rate was increased to 18 mm in the first hour. There were no other significant biochemical findings and fine-needle biopsy of one of the nodules showed nonspecific inflammatory reaction.


METHODS
Sonography revealed two lymph nodes, 7 and 22 mm in diameter. Suspected cat scratch disease was confirmed by immunofluorescence with Bartonella (Rochalimaea) henselae and quintana antigens.


METHODS
After a course of Clarithromycin (250 mg twice daily) for 6 weeks the lymph nodes had shrunk and the overlying skin was thin and discoloured brown. One node was incised and drained and the material examined. Microbiology was negative, but DNA sequencing confirmed Bartonella henselae. As a consequence, Rifampicin was given for 2 months (600 mg daily). Wound healing was very slow and the scar had regressed little after 9 months.
Heizmann
W R
WR
Institut für Virologie, Infektiologie und Epidemiologie, Stuttgart.
Schalasta
G
G
Moling
O
O
Pegoretti
S
S
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D018416:Bartonella henselae / Q000276:immunology*; D002372:Cat-Scratch Disease / Q000235:genetics* / Q000276:immunology*; D004269:DNA, Bacterial / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008208:Lymphatic System / Q000382:microbiology*
D000907:Antibodies, Bacterial; D004269:DNA, Bacterial