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Bacteria in Skin at the Primary Inoculation Site

Andrew W. Margileth, MD; COL Douglas J. Wear, MC; Capt Ted L. Hadfield, BSC; CDR Charles J. Schlagel, MSC; G. Thomas Spigel, MD; Jan E. Muhlbauer, MD

JAMA. 1984;252(7):928-931.

Abstract
Cat-scratch disease is a zoonotic infection characterized by a skin papule at the site of the scratch followed by regional lymphadenitis. Recently, small gram-negative pleomorphic bacilli were demonstrated in sections of lymph node from patients with the disease. We now report identical bacteria in the primary inoculation site of three patients with cat-scratch disease. Lymph nodes from two of these patients also contained the same bacilli. Identical bacteria in both skin and lymph nodes from these patients are further evidence that the bacilli are the cause of cat-scratch disease. In early infections, biopsy of the primary site of inoculation and demonstration of bacilli may replace excision and histologic examination of lymph node in establishing the diagnosis of cat-scratch disease.

(JAMA 1984;252:928-931)

Author Affiliations
USAR; USAF; USN

From the Department of Pediatrics, Uniformed Services University of the Health Sciences, F. Edward Hebert School of Medicine, Bethesda, Md (Dr Margileth); the Geographic Pathology Division (Dr Wear), the Bacteriology Branch (Dr Hadfield), and the Virology Branch (Dr Schlagel), Armed Forces Institute of Pathology, Washington, DC; the Department of Dermatology, Olean (NY) Medical Group (Dr Spigel); and the Muhlbauer Dermatopathology Laboratory, Pittsford, NY (Dr Muhlbauer).

Footnotes
The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Uniformed Services University of the Health Sciences, the Department of Defense, the US Army, or the Armed Forces Institute of Pathology.

Reprint requests to Department of Pediatrics, Uniformed Services University, 4301 Jones Bridge Rd, Bethesda, MD 20814 (Dr Margileth).

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