Slater L N, Welch D F, Min K W
Department of Medicine, University of Oklahoma College of Medicine, Oklahoma City.
Arch Intern Med. 1992 Mar;152(3):602-6.
Recent studies have demonstrated that a newly described agent of persistent bacteremia, Rochalimaea henselae, and the agent of bacillary angiomatosis are both closely related to Rochalimaea quintana. Bacillary peliosis hepatis seemed likely to have the same etiologic agent as bacillary angiomatosis. We sought these pathologic changes in patients from whom R henselae was cultivated.
For two patients whose histopathologic findings we reviewed, additional light and electron microscopy were performed. Their bacterial isolates were compared by electrophoretic patterns of outer membrane proteins, restriction endonuclease digestion patterns of DNA, and reaction with murine antiserum.
A previously reported human immunodeficiency virus-infected man with persistent bacteremia due to R henselae was found to have bacillary peliosis hepatis. Rochalimaea henselae was also isolated from the spleen of a woman receiving immunosuppressive therapy after allogeneic renal transplantation. She had developed fever, liver and spleen nodules, and periaortic lymphadenopathy. Bacillary peliosis of her liver and spleen, as well as bacillary angiomatosis of liver, spleen, and a lymph node, were found. The bacterial isolates had comparable electrophoretic patterns of outer membrane proteins and of restriction endonuclease-digested DNA, which differed from the respective patterns of R quintana. Murine antisera raised to the first isolate reacted strongly with the second by means of immunoblot and immunofluorescence techniques, while reacting only weakly with R quintana.
Rochalimaea henselae, recently recognized to cause persistent fever and bacteremia in immunocompetent and immunocompromised persons, also causes bacillary angiomatosis and parenchymal bacillary peliosis.
最近的研究表明,一种新描述的持续性菌血症病原体——汉赛巴通体,以及杆菌性血管瘤的病原体,都与五日热巴通体密切相关。肝杆菌性紫癜似乎与杆菌性血管瘤有相同的病原体。我们在培养出汉赛巴通体的患者中寻找这些病理变化。
对于两名我们复查了组织病理学结果的患者,进行了额外的光镜和电镜检查。通过外膜蛋白的电泳图谱、DNA的限制性内切酶消化图谱以及与鼠抗血清的反应,对他们的细菌分离株进行了比较。
一名先前报道的因汉赛巴通体导致持续性菌血症的人类免疫缺陷病毒感染男性,被发现患有肝杆菌性紫癜。在一名接受同种异体肾移植后接受免疫抑制治疗的女性的脾脏中也分离出了汉赛巴通体。她出现了发热、肝脏和脾脏结节以及主动脉旁淋巴结病。发现她的肝脏和脾脏有杆菌性紫癜,以及肝脏、脾脏和一个淋巴结有杆菌性血管瘤。细菌分离株的外膜蛋白电泳图谱和限制性内切酶消化DNA的图谱具有可比性,这与五日热巴通体的相应图谱不同。用第一种分离株制备的鼠抗血清通过免疫印迹和免疫荧光技术与第二种分离株发生强烈反应,而与五日热巴通体仅发生微弱反应。
汉赛巴通体最近被认为可在免疫功能正常和免疫功能低下的人群中引起持续性发热和菌血症,它也可引起杆菌性血管瘤和实质性杆菌性紫癜。