Inguinal swelling in a 5-year-old girl.
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Cat-Scratch Disease↗
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[Fever of unknown origin].
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Bartonella henselae↗
Macrophages (histiocytes) in various reactive and inflammatory conditions express different antigenic phenotypes.
The purpose of this study was to determine whether human tissue macrophages (M phi s) in various inflammatory/reactive conditions express different immunophenotypes. Using a large panel of monoclonal antibodies to monocyte/M phi-related antigens and a frozen-section immunoperoxidase technique, the following conditions were studied: granulomatous inflammation of unknown etiology, sarcoidosis, cat-scratch fever, toxoplasmosis, Gaucher's disease, and juvenile xanthogranulomas. The results show that there is immunophenotypic variation of the M phi s among the various inflammatory/reactive conditions. For example, the M phi s in cat-scratch fever are nearly unique in the expression of the "early inflammation" antigen identified by antibody 27E10, and the M phi s in juvenile xanthogranulomas, unlike those in most of the other conditions, lacked the antigen detected by antibody 25F9. The M phi s in Gaucher's disease differed from those in the other disorders by the combined absence of CD11b, CD14, G16/1, CD1a, CD25, and CD30. The inflammatory/reactive M phi s also exhibited differences from those in "normal" tissues, namely, a tendency toward acquisition of the antigens identified by antibodies Mac 387 and G16/1 and the more uniform expression of the "activation" antigens CD25, CD30, and CD71. The antigenic variations described here probably reflect differences in antigenic stimuli and M phi function. In addition to the possible biologic implications, this M phi immunophenotypic diversity may have practical diagnostic applications.
Antigens↗
Lymphocutaneous Nocardia brasiliensis infection acquired from a cat scratch: case report and review.
Nocardia brasiliensis is a bacterium that is most commonly found in the soil. Traumatic inoculation of N. brasiliensis into the skin is the most typical mode of acquisition of infection due to this organism. To the best of my knowledge, I report the first case of lymphocutaneous N. brasiliensis disease from a penetrating cat scratch of the skin, thereby establishing cats as vehicles for the transmission of this infection. Treatment with penicillin produced a rapid resolution of all signs and symptoms of infection. The efficacy of penicillin against the N. brasiliensis isolate recovered from this patient was highly unusual. In general, penicillin has limited therapeutic value since these organisms elaborate beta-lactamase. Sulfonamides remain the drugs of choice for the treatment of these infections. These soil-borne organisms are most likely carried on the claws of cats and may establish infection after percutaneous inoculation. A high index of suspicion for N. brasiliensis soft-tissue infection is required since a delayed or missed diagnosis may be associated with progressive local disease and/or widespread disseminated infection.
Adult↗
The epidemiology of bacillary angiomatosis and bacillary peliosis.
OBJECTIVE: To determine environmental risk factors for bacillary angiomatosis-bacillary peliosis (BAP), and to confirm infection with Rochalimaea species. DESIGN: Case-control study. SETTING: Community and university hospitals and clinics. PATIENTS: Case patients (N = 48) had biopsy-confirmed BAP. Controls (N = 94) were matched to patients by institution and by human immunodeficiency virus (HIV) serological status. MAIN OUTCOME MEASURES: Clinical information was obtained from medical records. Subjects were queried about environmental exposures. Univariate odds ratios (ORs) with 95% confidence intervals (CIs) were determined. Bivariate analyses were performed on variables associated with disease by univariate analysis. DNA from 22 available case-patient tissues and from 22 control tissues was amplified with the polymerase chain reaction (PCR) using primers designed to detect Rochalimaea species. RESULTS: We identified five HIV-negative, immunocompetent case patients; one HIV-negative, immunodeficient case patient; and 42 HIV-positive case patients. There were no significant differences between case patients and controls by race, sex, age, or risk factors for HIV infection. Owning a cat (OR, 2.8; CI, 1.4 to 5.8) and history of a recent cat lick (OR, 1.95; CI, 1.0 to 3.8), cat scratch (OR, 3.7; CI, 1.7 to 8.0), or cat bite (OR, 3.9; CI, 1.8 to 8.9) were associated with disease in the univariate analysis. In bivariate analyses, only the variables representing traumatic contact with a cat (bite or scratch) remained associated with disease. No other environmental exposure was associated with disease. The PCR amplified a DNA fragment of the size expected for Rochalimaea species in all 22 case-patient tissue specimens. CONCLUSIONS: These data suggest that BAP is a new zoonosis associated with both traumatic exposure to cats and infection with Rochalimaea species or a closely related organism.
Adult↗
Infections and some other conditions affecting the skin and subcutis of the naso-ocular region of cats--clinical experience 1987-2003.
Infections of the skin or subcutis of the naso-ocular region develop through two mechanisms. Cases with lesions but without concomitant signs of nasal disease probably result from cat scratch injuries. Under certain circumstances, such lacerations result in the introduction of saprophytic microorganisms in such large numbers that host defence mechanisms are overwhelmed. This results in localised, variably invasive, disease in an otherwise immunocompetent host. An unpredictable range of organisms can give rise to such infections including a variety of fungal and bacterial genera. Causal organisms will likely vary from one geography to another as a result of differences in soil type and related environmental factors. Accordingly, procurement of appropriate tissue specimens for culture and susceptibility testing is essential to guide therapy, as these cases require medical and sometimes surgical intervention in order to effect a favourable outcome. In contrast, patients with naso-ocular lesions and concurrent signs of nasal disease have a different pathogenesis. Primary infection of the sinonasal region likely results from the inhalation of infectious propagules, with the infection subsequently penetrating overlying bones to invade the subcutaneous space. These lesions are typically the result of cryptococcosis or aspergillosis and must be distinguished from invasive nasal malignancies. An approach to the investigation and treatment of these patients is presented together with photographs of representative cases.
Animals↗
Parinaud oculoglandular syndrome and cat-scratch fever.
The clinician should examine for conjunctival inflammation when preauricular adenopathy exists. Parinaud oculoglandular syndrome is probably caused by many different antigens, including CSD. Biopsy of the affected node is seldom indicated but may be necessary to help rule out neoplastic disease.
Adolescent↗
Acute bacterial suppurative parotitis: microbiology and management.
The parotid gland is the salivary gland most commonly affected by inflammation. The most common pathogens associated with acute bacterial parotitis are Staphylococcus aureus and anaerobic bacteria. The predominant anaerobes include gram-negative bacilli (including pigmented Prevotella and Porphyromonas spp.), Fusobacterium spp., and Peptostreptococcus spp. Streptococcus spp. (including S. pneumoniae) and gram-negative bacilli (including Escherichia coli) have also been reported. Gram-negative organisms are often seen in hospitalized patients. Organisms less frequently found are Arachnia, Haemophilus influenzae, Klebsiella pneumoniae, Salmonella spp., Pseudomonas aeruginosa, Treponema pallidum, cat-scratch bacillus, and Eikenella corrodens. Mycobacterium tuberculosis and atypical mycobacteria are rare causes of parotitis. Therapy includes maintenance of hydration and administration of parenteral antimicrobial therapy. Once an abscess has formed surgical drainage is required. The choice of antimicrobial depends on the etiologic agent. Maintenance of good oral hygiene, adequate hydration, and early and proper therapy of bacterial infection of the oropharynx may reduce the occurrence of suppurative parotitis.
Abscess↗
[Tuberculosis of the peripheral lymph nodes].
In Germans as well as in "foreign workers" acute tuberculous lymphnode disease is most often seen in the drainage areas of old sometimes even calcified tuberculous processes. The infective agent is almost always mycobacterium tuberculosis. Resistant strains are rarely found even in recurrent disease. Differential diagnosis includes tulareaemia, cat scratch syndrome, lues, and foreign body reaction. In those cases in which the histopathologic findings are similar to productive tuberculosis, sarcoidosis and epitheloid cell reaction in the drainage area of malignant tumors have to be taken into account. Knowing the usual good-response to tuberculostatic drugs there is no need to perform risky operations or to utilize rather dangerous agents such as streptomycine.
Adolescent↗
[New case of adenopathy from a cat scratch].
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Cats↗
[Infectious skin diseases in childhood. 1: Bacteria and fungi].
Infections may lead to a multitude of pathological skin alterations, and represent the most common diseases in pediatric dermatology. A prerequisite for successful treatment is an accurate diagnosis based on the medical history, clinical presentation and the culture of pathogens. Of importance among the bacterial skin diseases in pediatrics are impetigo, scarlet fever, borreliosis and cat-scratch fever. Dermatophytoses caused by Trichophyton or species of Microsporum affect either hair-bearing skin (scalp) (tinea capitis) or non-hair-bearing skin of the face, trunk, neck and limbs (tinea corporis). In babies, infections with the yeast fungus, Candida albicans, often develops from diaper rash. In addition to measles, rubella and varicella, viral dermatoses in children include herpes simplex or infections with Papillomavirus. Characteristic cutaneous alterations may also be caused by parasites, such as the scabies (itch) mite, and the head louse.
Child↗
Zoonotic skin diseases of dogs and cats.
Although there are over 250 zoonotic diseases, only 30-40 of them involve dogs and cats. Transmission of zoonotic infections occurs via bites, scratches or touch; exposure to saliva, urine or feces; inhalation of particles or infectious aerosols; contact with a transport or intermediate host (e.g. ticks, fleas); or exposure to contaminated water, soil or vegetation. This paper summarizes the most important common zoonotic dermatological diseases of dogs and cats. The most common dermatological zoonoses are flea and tick infestations and the diseases they transmit; dermatophytosis; and mite infestations (Sarcoptes and Cheyletiella). Prevention of zoonotic infestations or infections can be accomplished easily by the use of routine flea and tick control, screening of new pets for dermatophytosis, and routine hand-washing.
Animals↗
Risk factors associated with clinical signs of lower urinary tract disease in indoor-housed cats.
OBJECTIVE: To determine associations between environmental and cat-related factors and lower urinary tract signs in indoor-housed domestic cats. DESIGN: Case-control study. Animals-238 healthy cats, 157 cats with clinical signs of lower urinary tract disease, and 70 cats with other diseases. PROCEDURE: Data collected from owners of the cats were analyzed. Descriptive statistics, environmental variables, and physical and behavioral signs were analyzed by use of ANOVA and logistic regression analysis to assess which factors were associated with clinical signs of lower urinary tract disease. RESULTS: The only demographic or environmental factors associated with lower urinary tract signs were older age and months owned. In contrast, cats with clinical signs of lower urinary tract disease had significantly greater owner-observed gastrointestinal tract signs and scratching, fearful, nervous, and aggressive behaviors. CONCLUSIONS AND CLINICAL RELEVANCE: Lower urinary tract signs in indoor-housed cats may be more closely associated with cat-related factors than with demographic or environmental factors.
Age Factors↗
Lymphoreticular disease masquerading as or associated with an inguinal or femoral hernia.
Twelve patients (eight men and four women) had previously undiagnosed lymphoreticular disease associated with or simulating an inguinal (nine) or femoral (three) hernia. The disease was present on the left side in eight. Four patients (three women and one man) did not have an actual hernia. Two of these women had a preoperative diagnosis of femoral hernia. Seven of the patients, including all of the women, had non-Hodgkin's lymphoma (three diffuse large cell, two follicular mixed cell and two follicular small cleaved cell) and one patient had lymphocytic predominance (nodular lymphocytic and histiocytic) Hodgkin's disease. No stage predominated. Inguinal lymph nodes from two patients showed, histologically, Kaposi's sarcoma and type I human immunodeficiency virus (HIV) associated disease. Each patient was homosexual and HIV seropositive. Changes suggestive of viral cause were present in the lymph node of one patient. The enlarged lymph nodes of the 12th patient showed stellate suppurative granulomas containing cat-scratch bacilli demonstrated by Warthin-Starry stain. Because of the special processing needs for lymphoreticular diseases and potential for misdiagnosis, surgeons, clinicians and pathologists should be aware of the spectrum of lymphoreticular processes occurring in lymph nodes associated with or masquerading as a hernia, particularly in women.
Adult↗
Cat-transmitted sporotrichosis epidemic in Rio de Janeiro, Brazil: description of a series of cases.
Sporotrichosis is the most common subcutaneous mycosis in South America. Classic infection is associated with traumatic inoculation of soil, vegetables, and organic matter contaminated with Sporothrix schenckii. Zoonotic transmission has been described in isolated cases or in small outbreaks. Since 1998, we have been observing an increasing number of cases of sporotrichosis in persons from the city of Rio de Janeiro, Brazil, and surroundings. From 1998 to 2001, 178 cases of culture-proven sporotrichosis had been diagnosed. Female patients predominated, and the median age was 39 years. The most frequent clinical presentation was lymphocutaneous disease. Of the 178 patients, 156 reported domiciliary or professional contact with cats with sporotrichosis, and 97 of these patients had a history of receipt of cat scratch or bite. The patients received itraconazole as first-line treatment. This study suggests that feline transmission of sporotrichosis was associated with a large and long-lasting outbreak of the disease in Rio de Janeiro.
Adolescent↗
Cat cuddler's cough.
Pasteurella multocida typically causes cutaneous infections in humans following animal bites or scratches. Primary pulmonary disease, however, can occur in humans after inhalation of airborne particles or by aspiration of colonized or infected nasopharyngeal secretions containing this organism. Symptoms of P. multocida pulmonary infection in humans are variable, ranging from cough with or without hemoptysis to severe prostration. P. multocida infection of the lower respiratory tree has a predilection for elderly patients with underlying lung pathology, especially chronic obstructive pulmonary disease and bronchiectasis. This report reminds the clinician that P. multocida can cause pulmonary infection in patients without underlying lung disease, and stresses the importance of careful history when presented with an indolent infection.
Aged↗
Novel cases of blastomycosis acquired in Toronto, Ontario.
Blastomycosis a potentially fatal fungal disease, is well known from defined areas of endemicity in Ontario, primarily in the northern part of the province. We present 2 unusual cases that appear to extend the area of endemicity into urban southern Ontario, specifically Toronto. Both patients presented to a dermatology clinic with skin lesions. Chest radiography, history and general physical evaluation indicated no disease at other body sites. Both cases appeared to represent "inoculation blastomycosis" connected with minor gardening injuries and a cat scratch respectively. Atypical dissemination could not be completely excluded in either case. Neither patient had travelled recently to a known area of high endemicity for blastomycosis, nor had the cat that was involved in one of the cases. Physicians must become aware that blastomycosis may mimic other diseases, including dermal infections, and may occur in patients whose travel histories would not normally suggest this infection.
Adult↗
[Cutaneous zoonoses transmitted by dogs and cats].
Pets like dogs and cats are responsible for a series of zoonotic disorders. Some of these diseases are inflicted by bites, scratches or licking. Others result from a close contact with fur, or are transmitted by ectoparasites or by the contaminated environment. Some systemic infectious and parasitic diseases are transmitted from animals to humans and vice versa. Such situation may lead to endemic problems in some communities.
Animals↗