Abstract
Attempts were made to culture the etiologic agent of CSD using lymph node specimens from patients with clinical evidence of CSD and the presence of typical organisms on Warthin-Starry stains of lymph node sections. One lymph node grew 2 identical colonies on a glucose-peptone-yeast-soil extract agar plate which had been incubated at room temperature for 10 days. Gram stains of this isolate revealed gram-positive to gram-variable pleomorphic rods similar to the forms seen in the Warthin-Starry stains of lymph node sections. Transmission electron micrographs (EM) of the isolate revealed all of the morphologic forms identified by light microscopy as well as all of the morphologic forms seen on EM of lymph node sections from 2 patients with CSD. The EM of the isolate demonstrated a cell wall structure consistent with a gram-positive organism, while the EM of the lymph node sections demonstrated organisms lacking a cell wall. This apparent loss of the cell wall in vivo may explain earlier descriptions of this organism as gram-negative or gram-variable on tissue Gram stains. This isolate morphologically and biochemically resembles an organism first isolated approximately 50 years ago from cases of the Parinaud's syndrome form of CSD. Preliminary studies have demonstrated the ability of this isolate to produce granulomatous lesions in mice and a cell-mediated immune response in guinea pigs. Work is in progress to further define the characteristics and pathogenicity of this organism.
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Gerber, M., Sedgwick, A., Ballow, M. et al. 1096 ISOLATION OF THE ETIOLOGIC AGENT OF CAT SCRATCH DISEASE (CSD). Pediatr Res 19, 293 (1985). https://doi.org/10.1203/00006450-198504000-01126
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DOI: https://doi.org/10.1203/00006450-198504000-01126