Publications by authors named "AM Margileth"

. Prior reports on large congenital melanocytic nevi (LCMN) do not provide a clear management approach to physicians to advise parents or patients. Whether the presence of a halo around the nevus can guide management has not been fully explored.

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The cause of cat scratch disease (CSD), first described in France in 1950 and in the United States in 1951, was unknown until 1983 when the bacterium in lymph nodes was detected using a Warthin-Starry silver stain. Afipia felis has been an infrequent cause of CSD since1988, when this gram-negative bacterium was first isolated from 10 patients with CSD. In 1992 Bartonella organisms were isolated from immunocompetent and immunocompromised patients.

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We describe a patient who presented with a massive chest-wall abscess after a severe debilitating illness that lasted 3 months. Steroid therapy, administered for 4 weeks, masked the slow development of an extensive axillary and chest-wall abscess. After multiple negative tests, the patient's prolonged illness was diagnosed as cat-scratch disease (CSD).

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During 24 months in an uncontrolled, retrospective study of 268 patients with cat-scratch disease (CSD), 202 were treated with 18 different antimicrobial agents. Criteria for antibiotic effectiveness were established. One or two antibiotics were taken separately for at least 3 to 5 days by 202 patients with CSD.

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Cat scratch disease is a relatively common cause of localized lymphadenopathy with about 80% of cases occurring in children. This self-limited infection is caused by a small pleomorphic gram-negative bacillus that has been identified in ocular granulomas, skin and lymph node specimens. Unusual manifestations of the disease, such as the oculoglandular disease of Parinaud, encephalopathy, or severe systemic disease, occur in about 12% of patients.

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Seventy-six patients with neurologic complications of cat-scratch disease are discussed. Encephalopathy occurred in 61, while 15 had either cranial or peripheral nerve involvement. The average age of the patients with encephalopathy was 10.

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A gram-negative bacterium or its cell wall-defective variants were isolated from lymph nodes of ten patients with cat-scratch disease. Cultured bacteria were morphologically identical to vegetative and wall-defective forms seen in human tissues. Three of seven patients with recent cat-scratch disease had fourfold or greater rises in antibody titer against the cultured bacteria; the remaining four patients had maximum titers of 1:32 to 1:128.

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Cat scratch disease is a relatively common cause of chronic (three weeks or longer) lymphadenopathy, with 80% of cases occurring in children and adolescents. This self-limited infection caused by a small, gram-negative, pleomorphic bacillus has been identified in ocular granuloma, skin inoculation lesions, and lymph node specimens. Dermatologic manifestations observed prospectively in 908 patients included primary cat scratch inoculation papules, pustules or rarely, vesicles.

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Cat scratch disease.

Infect Dis Clin North Am

September 1987

In summary, CSD is a relatively common cause of localized lymphadenopathy, with 80 per cent of cases occurring in children. This self-limited infection is caused by a small pleomorphic bacillus that has been identified in ocular granuloma, skin, and lymph node specimens. Unusual manifestations of the disease such as the oculoglandular disease of Parinaud, encephalopathy, or severe systemic disease occur in about ten per cent of patients.

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Over a seven-year period, we identified 23 patients who had prolonged or recurrent, severe, systemic, cat-scratch disease (CSD). Compared with the usual, benign course in 1,038 patients with typical CSD, the course in these 23 patients included prolonged (two or more weeks) morbidity (fever, malaise, fatigue, myalgia, arthralgia, skin eruptions, weight loss, and splenomegaly). Five patients with systemic CSD had either neuroretinitis, pleurisy, arthralgia or arthritis, splenic abscesses, and mediastinal masses or enlarged nodes of the head of the pancreas.

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Cat scratch disease. A therapeutic dilemma.

Vet Clin North Am Small Anim Pract

January 1987

Cat scratch disease, a relatively common infectious disease, is caused by a small gram-negative pleomorphic bacillus. The course of CSD is usually benign and self-limiting and is characterized by tender regional chronic (3 weeks or longer) lymphadenopathy and frequently preceded by a primary skin lesion following cat contact or scratches. Persistence of adenopathy for several months in a generally healthy patient with gradual spontaneous resolution of the enlarged node is the natural course.

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We describe a renal allograft recipient with cat-scratch disease in whom refractory hypotension, severe metabolic acidosis, pulmonary infiltrates, and encephalopathy developed. The patient first presented with a history of cat bites and scratches, fever, headache, and arthralgias. Four weeks later, the clinical presentation of septic shock suddenly developed in the patient.

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Unilateral conjunctivitis with regional lymphadenitis has been designated Parinaud's oculoglandular syndrome (POGS). The cause has been attributed to various infectious agents, especially leptothrix and the unidentified agent of cat scratch disease (CSD). In 1983-84 the cause of CSD in lymph node and skin was established as small pleomorphic gram-negative bacilli.

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