ABSTRACT
In this review, representative types of granulomatous lymphadenitis (GLA) are described. GLA can be classified as noninfectious GLA and infectious GLA. Noninfectious GLA includes sarcoidosis and sarcoid-like reaction. The cause of sarcoidosis remains unknown, but it has good prognosis. Sarcoid-like reaction, which is considered to be a biological defense mechanism, is observed in regional lymph nodes with many underlying diseases. Infectious GLA can be classified as suppurative lymphadenitis (LA) and nonsuppurative LA. Suppurative LA generally shows follicular hyperplasia and sinus histiocytosis in the early phase. In tularemia and cat scratch disease, monocytoid B lymphocytes (MBLs) with T cells and macrophages contribute to the formation of granuloma. However, none of the epithelioid cell granulomas of Yersinia LA contains MBLs like in cat scratch disease. In addition, almost all have a central abscess in granulomas induced by Gram-negative bacteria. In terms of the lymph nodes, tularemia and cat scratch disease are apt to affect the axillary and cervical regions while Yersinia LA affects the mesenteric lymph node. Nonsuppurative LA includes tuberculosis and BCG-histiocytosis. These are induced by delayed allergic reaction of M. tuberculosis. Tuberculosis LA mainly appears in the cervical lymph node. Organisms are histologically detected by Ziehl-Neelsen staining in the necrotic area. Toxoplasmosis is also a nonsuppurative protozoan infection (Toxoplasma gondii). In toxoplasma LA, MBLs can also be seen, but round and organized, well-formed granulomas are not found in this disease. Furthermore, necrosis is not induced and there are no accompanying neutrophils, eosinophils and fibrosis. GLA described above is associated with characteristic histological findings. An accurate pathological diagnosis using the above findings can lead to precise treatment.
Subject(s)
Cat-Scratch Disease , Lymph Nodes/pathology , Sarcoidosis , Animals , Cat-Scratch Disease/classification , Cat-Scratch Disease/diagnosis , Cat-Scratch Disease/etiology , Cat-Scratch Disease/pathology , Gram-Negative Bacterial Infections/classification , Gram-Negative Bacterial Infections/diagnosis , Gram-Negative Bacterial Infections/pathology , Granuloma/classification , Granuloma/diagnosis , Granuloma/etiology , Granuloma/pathology , Humans , Sarcoidosis/classification , Sarcoidosis/diagnosis , Sarcoidosis/etiology , Sarcoidosis/pathologyABSTRACT
The cat-scratch disease (CSD) is known as a nosological entity since 1950. It was diagnosed by the clinical symptoms, epidemiologic data, and the intracutaneous test of Hanger and Rose. The aetiologic agent is Bartonella (formerly Rochalimaea) henselae occurring in thirty to fifty percent of healthy cats. The gramnegative alpha-2-proteobacteria cause the CSD but also fever in healthy humans. Patients suffering from AIDS show bacillary angiomatosis, bacillary peliosis hepatis, endocarditis, and septicemia. There is an open question for other aetiologic agents causing CSD as cofactors. For example, Afipia felis is found to a certain extent from patients suffering from CSD. Furthermore, Rothia dentocariosa was isolated in lymphnodes of CSD patients, and also other grampositive rods may play an important role together with B. henselae in CSD.
Subject(s)
Cat-Scratch Disease , AIDS-Related Opportunistic Infections/microbiology , Animals , Bartonella henselae/isolation & purification , Cat-Scratch Disease/classification , Cat-Scratch Disease/transmission , Cats/microbiology , Cross Infection , Diagnosis, Differential , Humans , Lymph Nodes/microbiologyABSTRACT
Descriçäo de um caso de doença da arranhadura de gato ou linforreticulose benigna, que envolve gânglios linfáticos que drenam os sítios dérmicos ou conjuntivais primários de inoculaçäo. A doença é autolimitada e benigna, mas pode, por vezes, progredir para infecçäo sistêmica grave e recorrente com encefalite, neuroretinite e osteomielite. Seu agente etiológico é a Rochalimaea benselae, um bacilo Gram-negativo pleomórfico de pequenas dimensöes, membro do subgrupo a-2 das a - proteobactérias
