Bacillary angiomatosis and the related disorders of bacillary peliosis hepatis and bacillary splenitis are manifestations of infection with Bartonella henselae and Bartonella quintana in immunocompromised persons. B. henselae infection, but not B. quintana infection, is linked to contact with cats and is presumed to cause visceral cat-scratch disease. We reports a case of visceral infection by B. henselae in an adult patient with cancer who was receiving chemotherapy and had had no contact with a cat or dog. The patient--whose illness was eventually diagnosed on the basis of findings of histologic, polymerase chain reaction, and serological studies--was treated with doxycycline and rifampin, and the infection resolved. In addition, 41 cases of documented or suspected bartonella infection of the liver, spleen, or both in immunocompetent or immunocompromised hosts are reviewed.
Recurrence of disease after Haemophilus influenzae bacteremia is relatively uncommon and may often be preventable. Three previously unreported and 11 reported occurrences in ten patients were evaluated in regard to pathogenesis. Recrudescence can be prevented by adequate culturing prior to therapy, proper treatment based on complete sensitivity testing and pharmacologic principles, and careful evaluation of clinical and microbiologic response. Relapse may be prevented in some instances by administering prophylactic rifampin to patients and close contacts who may be carriers of an infecting strain. Reinfections may be prevented through public health measures and the development of effective vaccines.
Infection due to serogroup Y of Neisseria meningitidis has many clinical manifestations, ranging from mild bacteremia to fatal sepsis and meningitis. N. meningitidis infection may coincide with several complement deficiencies. A child is described who suffered from recurrent disease due to N. meningitidis, group Y, attributed to deficiency of the eighth component of complement (C8). In a review of the literature, recurrent infection occurred in six of 13 children with complement deficiency, four of whom had serotyping positive for N. meningitidis, group Y. Screening for complement deficiency is recommended for all children with meningococcal disease due to N. meningitidis, group Y, and for any child with recurrent infection due to any Neisseria species.
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