title: Lymph node biopsy specimens and diagnosis of cat-scratch disease.
abstract: We report microbiologic analysis of 786 lymph node biopsy specimens from patients with suspected cat-scratch disease (CSD). The specimens were examined by standard, cell culture, and molecular methods. Infectious agents were found in samples from 391 (49.7%) of 786 patients. The most commonly identified infectious agent was Bartonella henselae (245 patients, 31.2%), the agent of CSD. Mycobacteriosis was diagnosed in 54 patients (6.9%) by culture and retrospectively confirmed by using a specific real-time PCR assay. Neoplasm was diagnosed in 181 specimens suitable for histologic analysis (26.0%) from 47 patients. Moreover, 13 patients with confirmed Bartonella infections had concurrent mycobacteriosis (10 cases) or neoplasm (3 cases). A diagnosis of CSD does not eliminate a diagnosis of mycobacteriosis or neoplasm. Histologic analysis of lymph node biopsy specimens should be routinely performed because some patients might have a concurrent malignant disease or mycobacteriosis.
authors.affiliation: Université de la Méditerranée, Marseille, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Rolain
authors.forename: Hubert
authors.initials: H
authors.lastname: Lepidi
authors.forename: Michel
authors.initials: M
authors.lastname: Zanaret
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Triglia
authors.forename: Gérard
authors.initials: G
authors.lastname: Michel
authors.forename: Pascal-Alexandre
authors.initials: PA
authors.lastname: Thomas
authors.forename: Michèle
authors.initials: M
authors.lastname: Texereau
authors.forename: Andreas
authors.initials: A
authors.lastname: Stein
authors.forename: Anette
authors.initials: A
authors.lastname: Romaru
authors.forename: François
authors.initials: F
authors.lastname: Eb
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001431:Bacteriological Techniques; D018416:Bartonella henselae / Q000235:genetics / Q000302:isolation & purification; D001706:Biopsy; D002372:Cat-Scratch Disease / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D002415:Cats; D002648:Child; D002675:Child, Preschool; D003470:Culture Media; D004269:DNA, Bacterial / Q000032:analysis; D005260:Female; D006801:Humans; D007223:Infant; D008198:Lymph Nodes / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009164:Mycobacterium Infections / Q000150:complications / Q000175:diagnosis; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis; D016133:Polymerase Chain Reaction; D012336:RNA, Ribosomal, 16S / Q000235:genetics
chemical_list: D003470:Culture Media; D004269:DNA, Bacterial; D012336:RNA, Ribosomal, 16S