NEURORETINITIS, ASEPTIC-MENINGITIS, AND LYMPHADENITIS ASSOCIATED WITHBARTONELLA (ROCHALIMAEA) HENSELAE INFECTION IN IMMUNOCOMPETENT PATIENTS AND PATIENTS INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1

Bartonella (Rochalimaea) henselae causes a variety of diseases, includ ing bacillary angiomatosis, peliosis hepatis, lymphadenitis, aseptic m eningitis with bacteremia, and cat-scratch disease (CSD). Cases of B. henselae-related disease were collected from September 1991 through No vember 1993. Patients with suspected CSD, unexplained fever and lympha denitis, or suspected B. henselae infection who were seen in the Infec tious Diseases Clinic at Wilford Hall Medical Center (Lackland Air For ce Base, TX) underwent physical and laboratory examinations. In additi on to three previously described cases, 23 patients with R. henselae-r elated infection were identified. The patients included 19 immunocompe tent individuals presenting with lymphadenitis (11), stellate neuroret initis (5), Parinaud's oculoglandular syndrome with retinitis (1), chr onic fatigue syndrome-like disease (1), and microbiologically proven a denitis without the presence of immunofluorescent antibodies to B, hen selae (1) and four patients infected with human immunodeficiency virus type 1 presenting with isolated lymphadenitis (1), diffuse upper-extr emity adenitis (1), neuroretinitis (1), and aseptic meningitis (1), A couple with neuroretinitis and their pet cat, a persistently fatigued patient, and a patient with Parinaud's oculoglandular syndrome were sh own to have bacteremia, Tissue cultures were positive for B. henselae in three recent cases of adenitis, Twenty-two patients were exposed to cats, This series further demonstrates the similarities between B. he nselae-related diseases and CSD and identifies several new syndromes d ue to B. henselae.