Gp. Jevon et al., AN ANALYSIS OF LYMPH-NODE DNA FOR POSSIBLE BACTERIAL AGENTS OF CAT-SCRATCH DISEASE, PEDIATRIC PATHOLOGY & LABORATORY MEDICINE, 15(1), 1995, pp. 3-9
Recent investigations have implicated Afipia felis and Rochalimaea hen
selae as possible agents of cat-scratch disease (CSD). We studied lymp
h nodes with necrotizing granulomas characteristic of CSD for A. felis
and R. henselae DNA so that the relationship of these organisms to ly
mph nodes with necrotizing granulomas of unknown etiology night be bet
ter defined. We examined formalin-fixed, paraffin-embedded lymph node
biopsies with necrotizing granulomas suggestive of CSD from 28 childre
n obtained over the last 10 years. None had identifiable bacteria, fun
gi, or acid-fast organisms on routine staining. Pleomorphic bacillary
structures consistent with the CSD bacillus were seen with the Steiner
stain in 17 cases. We performed the polymerase chain reaction (PCR) o
n the extracted lymph node DNA with DNA primers for these organisms af
ter demonstrating the presence of amplifiable DNA with c-K-Ras primers
. R. henselae was identified in two samples. A. felis DNA was found in
just one specimen. These putative CSD bacteria are infrequently assoc
iated with necrotizing granulomas using standard PCR techniques. It is
possible that some of the patients did not have clinical CSD. The pre
servation of DNA or numbers of bacteria in the extracted sections may
be inadequate for demonstration by DNA amplification methods. These ba
cilli may be responsible for a small proportion of these characteristi
c lesions of unknown etiology, or the typical CSD histology, including
the presence of pleomorphic bacillary structures, may be nonspecific.