Chapter 10 : : an Emerging Human Pathogen

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species have become recognized as substantial human pathogens associated with a wide spectrum of diseases. Four members of the genus are known to cause human infection: , , , and . Bacillary peliosis hepatis (BP) is a different vasculoproliferative histopathological entity that occurs in the liver and spleen and occasionally in lymph nodes. Patients with BP can develop thrombocytopenia or pancytopenia and elevated levels of hepatic enzymes, most commonly increased alkaline phosphatase. can be isolated directly from the cutaneous lesions of bacillary angiomatosis (BA), but recovery is even more difficult and may require cultivation of biopsied tissue with endothelial cells for weeks. It is likely that cat scratch disease (CSD) is the most commonly recognized infection of humans, affecting at least 22,000 people each year and costing more than $12 million annually for diagnosis and treatment in the United States alone. The identification of as the agent of CSD and the ability to culture this organism and detect antibodies to it have better defined the spectrum of CSD infection. As with other species, the transmission of these four species among small mammals is presumed to occur via arthropod vectors. Infection in immunocompromised hosts is associated with an unusual stimulation of vascular proliferation (BA), while infection with the same species, , causes an entirely different histopathological response (CSD) in immunocompetent hosts.

Citation: Koehter J. 1998. : an Emerging Human Pathogen, p 147-163. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch10
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Image of Color Plate 1.
Color Plate 1.

Two cutaneous bacillary angiomatosis lesions in the same patient, caused by . a friable, exophytic nodule of the finger and a more recently developed vascular papule of the scrotum. (Reprinted with permission from reference .)

Citation: Koehter J. 1998. : an Emerging Human Pathogen, p 147-163. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch10
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Image of Color Plate 2.
Color Plate 2.

Warthin-Starry silver staining of a cutaneous bacillary angiomatosis lesion demonstrates multiple clumps of tangled, dark silver-staining bacilli. Bar, 10 m. (Reprinted with permission from reference .)

Citation: Koehter J. 1998. : an Emerging Human Pathogen, p 147-163. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch10
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Image of Figure 1.
Figure 1.

Reservoirs. vectors, and mammalian infections associated with species. The species are shown in boxes. with the respective mammalian reservoir just below each box. 1be mode of transmission (arthropod vector or cat scratch) is shown next to each arrow. and the resultant mammalian infection is shown at the end of each arrow.

Citation: Koehter J. 1998. : an Emerging Human Pathogen, p 147-163. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch10
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Generic image for table
Table 1.

species and human infection

Citation: Koehter J. 1998. : an Emerging Human Pathogen, p 147-163. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch10

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