Cases reported "Rickettsiaceae Infections"

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1/7. Characterization of a novel Rochalimaea species, R. henselae sp. nov., isolated from blood of a febrile, human immunodeficiency virus-positive patient.

    Isolation of a Rochalimaea-like organism from a febrile patient infected with human immunodeficiency virus was confirmed. Analysis of 16S rRNA gene sequences, together with polymerase chain reaction and restriction endonuclease length polymorphism analysis of a portion of the citrate synthase gene, demonstrated that the agent is closely related to members of the genus Rochalimaea and that the isolate is genotypically identical to the presumptive etiologic agent of bacillary angiomatosis. However, the same genotypic analyses readily differentiated the new isolate from isolates of other recognized Rochalimaea species as well as other genera of bacteria previously suggested as putative etiologic agents of bacillary angiomatosis and related syndromes. We propose that the novel species be referred to as Rochalimaea henselae sp. now.
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ranking = 1
keywords = angiomatosis
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2/7. Isolation of Rochalimaea species from cutaneous and osseous lesions of bacillary angiomatosis.

    BACKGROUND. Bacillary angiomatosis is characterized by vascular lesions, which occur usually in patients infected with the human immunodeficiency virus (hiv). A newly described gram-negative organism, Rochalimaea henselae, has been associated with cutaneous bacillary angiomatosis, but no organism has been isolated and cultivated directly from cutaneous tissue. methods. We used two methods to isolate the infecting bacterium from four hiv-infected patients with cutaneous lesions suggestive of bacillary angiomatosis: cultivation with eukaryotic tissue-culture monolayers and direct plating of homogenized tissue onto agar. The patients' blood was cultured with the lysis-centrifugation method. Isolates recovered from skin and blood were identified by sequencing all or part of the 16S ribosomal rna gene amplified with the polymerase chain reaction. RESULTS. R. quintana, historically known as the agent of trench fever, was isolated from cutaneous lesions in three patients, after tissue homogenates were cultivated with endothelial-cell monolayers; R. henselae was isolated from a cutaneous lesion in one patient. In two patients, R. quintana was isolated from both cutaneous tissue and blood; in one patient it was also isolated from bone. CONCLUSIONS. In bacillary angiomatosis, either of two species of rochalimaea--R. quintana or R. henselae--can be isolated from cutaneous lesions or blood, providing an additional method of diagnosis.
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ranking = 4
keywords = angiomatosis
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3/7. Rochalimaea henselae causes bacillary angiomatosis and peliosis hepatis.

    BACKGROUND--Recent studies have demonstrated that a newly described agent of persistent bacteremia, Rochalimaea henselae, and the agent of bacillary angiomatosis are both closely related to Rochalimaea quintana. Bacillary peliosis hepatis seemed likely to have the same etiologic agent as bacillary angiomatosis. We sought these pathologic changes in patients from whom R henselae was cultivated. methods--For two patients whose histopathologic findings we reviewed, additional light and electron microscopy were performed. Their bacterial isolates were compared by electrophoretic patterns of outer membrane proteins, restriction endonuclease digestion patterns of dna, and reaction with murine antiserum. RESULTS--A previously reported human immunodeficiency virus-infected man with persistent bacteremia due to R henselae was found to have bacillary peliosis hepatis. Rochalimaea henselae was also isolated from the spleen of a woman receiving immunosuppressive therapy after allogeneic renal transplantation. She had developed fever, liver and spleen nodules, and periaortic lymphadenopathy. Bacillary peliosis of her liver and spleen, as well as bacillary angiomatosis of liver, spleen, and a lymph node, were found. The bacterial isolates had comparable electrophoretic patterns of outer membrane proteins and of restriction endonuclease-digested dna, which differed from the respective patterns of R quintana. Murine antisera raised to the first isolate reacted strongly with the second by means of immunoblot and immunofluorescence techniques, while reacting only weakly with R quintana. CONCLUSION--Rochalimaea henselae, recently recognized to cause persistent fever and bacteremia in immunocompetent and immunocompromised persons, also causes bacillary angiomatosis and parenchymal bacillary peliosis.
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ranking = 4
keywords = angiomatosis
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4/7. The agent of bacillary angiomatosis. An approach to the identification of uncultured pathogens.

    BACKGROUND. Bacillary angiomatosis is an infectious disease causing proliferation of small blood vessels in the skin and visceral organs of patients with human immunodeficiency virus infection and other immunocompromised hosts. The agent is often visualized in tissue sections of lesions with Warthin-Starry staining, but the bacillus has not been successfully cultured or identified. This bacillus may also cause cat scratch disease. methods. In attempting to identify this organism, we used the polymerase chain reaction. We used oligonucleotide primers complementary to the 16S ribosomal rna genes of eubacteria to amplify 16S ribosomal gene fragments directly from tissue samples of bacillary angiomatosis. The dna sequence of these fragments was determined and analyzed for phylogenetic relatedness to other known organisms. Normal tissues were studied in parallel. RESULTS. Tissue from three unrelated patients with bacillary angiomatosis yielded a unique 16S gene sequence. A sequence obtained from a fourth patient with bacillary angiomatosis differed from the sequence found in the other three patients at only 4 of 241 base positions. No related 16S gene fragment was detected in the normal tissues. These 16S sequences associated with bacillary angiomatosis belong to a previously uncharacterized microorganism, most closely related to Rochalimaea quintana. CONCLUSIONS. The cause of bacillary angiomatosis is a previously uncharacterized rickettsia-like organism, closely related to R. quintana. This method for the identification of an uncultured pathogen may be applicable to other infectious diseases of unknown cause.
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ranking = 5
keywords = angiomatosis
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5/7. Bacillary angiomatosis of the spleen.

    Bacillary angiomatosis is a recently described vasoproliferative lesion associated with infection by a newly characterized rickettsial organism, Rochalimaea henselae. Most previous reports have described skin lesions in immunocompromised patients infected with human immunodeficiency virus. This is the first case report detailing the features of bacillary angiomatosis of the spleen occurring in a patient undergoing cytotoxic chemotherapy for disseminated ovarian carcinoma.
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ranking = 3
keywords = angiomatosis
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6/7. Rochalimaea henselae infection. A new zoonosis with the domestic cat as reservoir.

    OBJECTIVE--To determine the reservoir and vector(s) for Rochalimaea henselae, a causative agent of bacillary angiomatosis (BA) and cat scratch disease, and to estimate the percentage of domestic cats with R henselae bacteremia in the Greater san francisco Bay Region of Northern california. DESIGN--Hospital-based survey of patients diagnosed with BA who also had significant exposure to at least one pet cat, as well as a convenience sampling of pet or impounded cats for prevalence of Rochalimaea bacteremia. SETTING--Community and university hospitals and clinics; veterinary clinics treating privately owned or impounded cats. patients--patients with or without human immunodeficiency virus infection, with biopsy-confirmed BA, who had prolonged exposure to pet cats prior to developing BA. MAIN OUTCOME MEASURES--Cultures and laboratory studies were performed on blood drawn from pet cats associated with patients with BA. The Rochalimaea species infecting pet cats and fleas and causing the BA lesions in human contacts of these cats was identified by culture, polymerase chain reaction-restriction fragment length polymorphism analysis, and dna sequencing. The presence of R henselae bacteremia in pet cats was documented, and predictor variables for culture positivity were evaluated. RESULTS--Four patients diagnosed with BA who had prolonged contact with seven pet cats were identified. The Rochalimaea species causing BA lesions in these patients was determined to be R henselae. The seven pet cats were found to be bacteremic with R henselae; this bacterium was also detected in fleas taken from an infected cat by both direct culture and polymerase chain reaction. Blood samples were cultured from pet and impounded cats (N = 61) in the Greater san francisco Bay Region, and R henselae was isolated from 41% (25/61) of these cats. CONCLUSION--We have documented that the domestic cat serves as a major persistent reservoir for R henselae, with prolonged, asymptomatic bacteremia from which humans, especially the immunocompromised, may acquire potentially serious infections. Antibiotic treatment of infected cats and control of flea infestation are potential strategies for decreasing human exposure to R henselae.
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ranking = 0.5
keywords = angiomatosis
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7/7. syndrome of Rochalimaea henselae adenitis suggesting cat scratch disease.

    OBJECTIVE: To describe a clinical syndrome of cat scratch disease caused by Rochalimaea henselae, including methods for isolation of the organism from tissue and for identification. DESIGN: Case series. SETTING: U.S. air Force referral hospital infectious diseases clinic. patients: Two previously healthy patients. MAIN MEASUREMENTS AND RESULTS: Two immunocompetent patients who had handled cats developed unilateral upper-extremity adenitis associated with a distal papular lesion and fever. The adenitis and distal lesions persisted and progressively worsened. Cultures of the involved lymph nodes from both patients grew R. henselae, a recently described organism associated with bacillary angiomatosis and peliosis hepatis in human immunodeficiency virus-infected patients and with bacteremia in immunocompromised and immunocompetent hosts. The organism was characterized as oxidase negative and X-factor dependent and had a characteristic pattern in analysis of whole-cell fatty acids differing from afipia felis, a bacterium that has been associated with cat scratch disease. The identity of the isolate was confirmed by analysis of whole-cell fatty acids using gas chromatography and by amplification of the citrate synthetase gene sequence and analysis of the polymerase chain reaction-amplified product. The organisms were broadly susceptible to a variety of antimicrobials by broth microdilution; however in-vitro resistance to first-generation cephalosporins correlated with clinical failure of therapy. CONCLUSION: Rochalimaea henselae can be a cause of cat scratch disease in immunocompetent patients.
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ranking = 0.5
keywords = angiomatosis
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