November 25, 1983

Has AFIP debugged the cat scratch mystery?

JAMA. 1983;250(20):2745-2747. doi:10.1001/jama.1983.03340200005003

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The discovery of a possible cause for cat scratch disease (CSD), a painful but benign disease that is often undiagnosed or misdiagnosed—partly because its etiology has baffled pathologists for 50 years—was announced recently by researchers at the Armed Forces Institute of Pathology (AFIP), Washington, DC, and the Uniformed Services University of the Health Sciences (USUHS), Bethesda, Md.

"We were amazed when we saw them," Douglas J. Wear, MD, of the AFIP, told JAMA MEDICAL NEWS. "We thought if we found bacteria, the illness couldn't be cat scratch disease, because most pathologists leaned toward a virus as being the causative agent."

Nonetheless, report Wear and colleagues, delicate pleomorphic gram-negative bacilli appear to be the etiologic agents (Science 1983;221:1403-1404).

The mysterious disease, which has been known as nonbacterial lymphadenitis, among other things, was first reported in 1950, although even then it had been recognized for at least 20 years. Diagnosis requires that