Lymph node biopsy specimens and diagnosis of cat-scratch disease.
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.
Rolain
Jean-Marc
JM
Université de la Méditerranée, Marseille, France.
Lepidi
Hubert
H
Zanaret
Michel
M
Triglia
Jean-Michel
JM
Michel
Gérard
G
Thomas
Pascal-Alexandre
PA
Texereau
Michèle
M
Stein
Andreas
A
Romaru
Anette
A
Eb
François
F
Raoult
Didier
D
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
D003470:Culture Media; D004269:DNA, Bacterial; D012336:RNA, Ribosomal, 16S