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In a 4-year-old boy with left-sided inguinal lymphadenopathy and a papule on his left lower leg situated at the end of a scar of a probable cat scratch, cat scratch disease was confirmed serologically.
Fleas are wingless insects that parasitize mammals and more rarely birds. They are able to jump and may bite people. Adult fleas are hematophagous. The impact of fleas on public health is related to their ability to act as vectors for transmission of infectious agents during blood meals. The purpose of this article is to describe fleas and the diseases that they transmit to humans. Special focus is placed on epidemiological aspects.
Cat scratch disease is an infection which often causes regional lymphadenopathy. Bartenolloses present a growing health problem both in human and veterinary medicine. They may be etiological fevers of unknown etiology, endocarditis, pneumonia, meningitis. The mildest clinical form is the cat scratch disease which proceeds as a mild regional lymphadenopathy. It is caused by Bartonellosis henselae. Animals, especially cats, are the sourse of infections. Lymphadenitis may remain for many weeks and requires differentiation from other causes of regional lymphadenopathy. Three typical cases of the disease are presented. All sick persons had contact with cats. In none case a primary change was observed. In the case no 1 the possibility of occurrence of the disease was not considered and it was diagnosed only after histopathological examination of lymphnodes. In the two other cases diagnoses were established on the basis of serological examination after a few days of admittance for hospital treatment. Cat scratch disease is rarely diagnosed in Poland probably due to insufficient knowledge of the clinical form of this disease. Swollen lymph nodes together with patient contact with a cat or other animals established during a detailed interviewing, raise suspicion of CSD. Denial by a patient of the primary change does not rule out diagnosis. When regional lymphadenopathy of cat scratch disease is taken into consideration in differential diagnosis and serological tests are carried out, it may be possible in many cases to eliminate any further diagnostics burdening a sick person.
Bacterial zoonoses are evolving with changes in society, climate and lifestyles. A hierarchy of non food-borne zoonoses was recently proposed in France, and includes characteristics such as severity criteria and bioterrorism potential. The creation of specific networks and reference centers has provided the means to monitor the emergence (or re-emergence) of zoonoses such as brucellosis and Q fever. Molecular tools have facilitated the detection of bacteria that are transmitted by arthropod vectors (ticks, fleas, etc.) and that cause diseases such as Lyme borreliosis, bartonellosis and ehrlichiosis.
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The history of human Bartonellosis, a unique South American biphasic bacterial disease, is reviewed. The course of this disease and its natural history offer many puzzling problems. Its geographic distribution, its absence of a natural reservoir, the development of transient immunosuppression during the acute hematic phase, and the subsequent development of vascular proliferations are highlighted. These vascular proliferations represent a unique example of tissue reactivity recalling the vascular proliferations of patients with AIDS. In addition, the authors review the life and times of Daniel Alcides Carrión, a Peruvian medical student who in 1885 by self-experimentation linked both phases of the disease and died in doing so. Carrión's life, and the impact of his experiment on the subsequent study of Bartonellosis by Peruvian and international scholars, epitomize the constant struggle of the Peruvian medical profession (past and present) to upgrade domestic biomedical research and to find a national identity.
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Two patients with acquired immunodeficiency syndrome developed simultaneous Kaposi's sarcoma and bacillary (epithelioid) angiomatosis. The distinguishing clinical and histologic features of these two vascular proliferations associated with human immunodeficiency virus disease are described. The lesions of bacillary (epithelioid) angiomatosis contained bacteria, while the lesions of Kaposi's sarcoma did not. With erythromycin therapy, the lesions of bacillary (epithelioid) angiomatosis cleared, while those of Kaposi's persisted. Bacillary (epithelioid) angiomatosis, a treatable but potentially fatal opportunistic infection of human immunodeficiency virus disease, should be considered in the differential diagnosis of vascular lesions in immunosuppressed patients.
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