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David Schlossberg, MD; Yosef Morad, MD; Theodore B. Krouse, MD; COL Douglas J. Wear, MC; LT Charles K. English, MSC

Arch Intern Med. 1989;149(6):1437-1439.

Abstract
• A male homosexual (positive for the human immunodeficiency virus) with a recent cat scratch developed fever, epitrochlear and axillary lymphadenopathy, and retinitis. Subsequently, he developed skin (epithelioid hemangioma) and mucosal lesions (Kaposi's sarcoma), multiple liver abscesses, and pleural effusion. Warthin-Starry stains and/or electron micrographs of lymph nodes and skin lesions demonstrated bacilli characteristic of those associated with cat-scratch disease. Cultures of lymph node, pleural fluid, and liver abscess specimens yielded organisms believed to be the causative agent of cat-scratch disease. We believe that disseminated cat-scratch disease may become an indicator of opportunistic infection signaling acquired immunodeficiency syndrome in a patient who is positive for the human immunodeficiency virus.

(Arch Intern Med. 1989;149:1437-1439)

Author Affiliations
USA; USN

From the Departments of Medicine (Drs Schlossberg and Morad) and Pathology (Dr Krouse), Episcopal Hospital, Philadelphia, Pa, and the Department of Infectious and Parasitic Disease Pathology, Armed Forces Institute of Pathology, Washington, DC (Dr Wear and Mr English).

Footnotes
Accepted for publication December 23, 1988.

The opinion and assertions herein are private views of the authors and are not to be construed as official opinions or reflecting views of the Department of Defense, the United States Army, or the Armed Forces Institute of Pathology.

Reprint requests to Department of Medicine, Episcopal Hospital, Front Street and Lehigh Avenue, Philadelphia, PA 19125 (Dr Schlossberg).

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