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Sub-plasmalemmal linear density: a common structure in globoid cells and mesenchymal cells.

Sub-plasmalemmal linear densities of variable length (0.1 approximately 1.0 mu) were found to be a constant feature of globoid cells in human as well as in canine globoid cell leukodystrophy (GLD). Similar densities were also observed in experimental globoid cells and epithelioid cells in chronic granuloma but not in glial cells. The linear densities always appeared without any relation to basal laminae. These observations together with the other reports of similar structures in lymphoma, fibroma and sarcoidosis suggest that the sub-plasmalemmal density is a structure frequently observed in mesenchymal cells, and may be another supporting feature for possible mesenchymal origin of globoid cells.

Animals↗

Detection of antibodies to Afipia species by the microagglutination test.

A microagglutination test with heat-killed, safranin-stained whole-cell antigen for detecting antibodies to Afipia species has been developed. An upper limit of the normal titer of antibodies to Afipia species was found to be > 10 by testing 430 sera. Therefore, a titer of 20 can be considered the lowest titer suggestive of infection. Overall, 5-7% of the sera were positive for Afipia felis, 3% were positive for Afipia broomeae and 11% were positive for Afipia clevelandensis. The frequency of sera positive for unnamed Afipia genospecies 1-3 was < 1%. The agglutinating antibodies belonged mainly to the IgM class.

Agglutination Tests↗

Widening of the clinical spectrum of Bartonella henselae infection as recognized through serodiagnostics.

UNLABELLED: The recently improved diagnostics have widened, in children, the spectrum of clinical manifestations recognisable as Bartonella henselae infection. We report here the clinical features of 20 (14 males) consecutive children with serologically proved B. henselae infection observed within 12 months in the Paediatric Department of the University of Pisa. The patients had a mean age of 7 years 4 months (range 1.1-14.1 years). All children but one had a history of contact with kittens. Clinical manifestations included regional lymphadenopathy in 14 patients, representing in five the only clinical manifestation at onset, infectious mononucleosis-like syndrome in six, erythema nodosum in three, and Parinaud oculoglandular syndrome in one. In five patients a severe disorder was first suspected: fever of unknown origin in two with multiple hepatosplenic granulomatosis in one; osteolytic lesion suggesting bone neoplasm, marked inguinal lymph-node enlargement, suggesting Burkitt lymphoma, and an acute encephalopathy in one each. Bartonella henselae IgG antibody was positive in all patients with a titre ranging from 1:128 to 1:8590. IgM antibody was present in all except one child with an IgG titre of 1:2048. All patients recovered, some spontaneously. CONCLUSION: Bartonella henselae infection is frequent in Tuscany and probably underdiagnosed due to the high frequency of atypical onset of the clinical manifestations. An accurate clinical history and a reasonably wide use of the serological test may allow a rapid and accurate diagnosis, reassuring the family of the patient and avoiding invasive and expensive diagnostic procedures.

Adolescent↗

Bacillary angiomatosis.

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AIDS-Related Opportunistic Infections↗

Optic disk edema associated with peripapillary serous retinal detachment: an early sign of systemic Bartonella henselae infection.

PURPOSE: To describe optic disk edema associated with peripapillary serous retinal detachment as an early sign of systemic Bartonella henselae infection. METHODS: Multicentered, retrospective case series. RESULTS: Five women and two men presented with optic disk edema producing peripapillary serous retinal detachment. Each patient had a markedly elevated serum anti-B. henselae antibody titer. Patient age ranged from 11 to 44 years, with a mean and median of 26.6 and 28 years, respectively. The time from the onset of systemic symptoms to the onset of visual symptoms varied from 3 days to 1 month. The peripapillary serous retinal detachment resolved within 1 to 3 weeks in each case, producing a macular star in four of seven patients. Initial vision was 20/200 or worse in five of seven patients and improved in four of these five patients to 20/30 or better. CONCLUSIONS: Systemic B. henselae infection should be considered in patients who develop optic disk edema associated with a peripapillary serous retinal detachment, even in the absence of classic neuroretinitis with a macular star.

Adolescent↗

Bartonella henselae infection associated with peripapillary angioma, branch retinal artery occlusion, and severe vision loss.

PURPOSE: To report atypical clinical features of Bartonella henselae neuroretinitis treated with combination antibiotics. METHOD: Case report. RESULTS: A 20-year-old man with a positive B. henselae titer developed a unilateral neuroretinitis, a large peripapillary angiomatous lesion, branch artery occlusion with ischemic maculopathy, and vision loss that failed to improve with clindamycin. Treatment with doxycycline and rifampin led to rapid clinical improvement. The severe vision loss in this case is atypical. CONCLUSIONS: Ocular findings associated with B. henselae infection may include retinal angiomatous lesion and branch retinal artery occlusion. Doxycycline and rifampin were successful in treating the infection.

Adult↗

Mycobacterial lymphadenitis.

The plan for cervical lymph node biopsy should include special maneuvers for recognition of patients with lymphadenitis due to atypical mycobacteria, since these children need extensive operations. The diagnosis should be suspected in children less than 3 yr old with lymphadenopathy present for several months and no exposure to cats (or with negative cat scratch skin tests). Wide local excision of all visibly involved nodes is recommended; acid-fast touch preparations should be done and interpreted during operation in any suspicious case. Limited operations should be avoided in children with mycobacterial lymphadenitis. The illness may be more common than previously suspected.

Cat-Scratch Disease↗