1534 Brief Reports CID 1998;27 (December)

doxycycline and prednisolone for 4 weeks. All symptoms resolved type hypersensitivity to tissue homogenates containing the (at that except for the adenopathy; the lymph node erupted spontaneously time) unknown agent of CSD. The skin test antigen is, however, on day 17 and revealed pus, which was sent to our laboratory to not commercially available and tissue homogenates bear the risk be evaluated for B. henselae. A fistula that developed at the inci- of transmitting pathogens. Thus, an in vitro lymphoproliferation sional area healed within a few weeks. She was discharged from assay might be a useful diagnostic adjunct, especially in cases for the hospital on day 22 and did well thereafter. which serologic results are equivocal. (After preparing this article, B. henselae DNA was isolated from the lymph node aspirate we studied the peripheral blood lymphocytes of another CSD pa-by using PCR amplification of citrate synthase gene and restriction tient, and found, as described in this report for the first time, a fragment length polymorphism (RFLP) analysis [2]. Culture for Bartonella-specific proliferation of her cells.) Bartonella species performed on solid agar media and incubated for up to 6 weeks did not yield B. henselae. Serology was per- Mardjan Arvand, Martin E. A. Mielke, Klaus Sterry, formed by using an indirect fluorescence assay (MRL, Cypress, and Helmut Hahn CA). Diagnostics serum samples collected at 2 and 6 weeks and Institut für Infektionsmedizin, Universitätsklinikum Benjamin Franklin, 8 months after admission yielded titers of 256, 128, and 32, respec- Freie Universität Berlin, and Abteilung für Innere Medizin, tively, for IgG antibodies to B. henselae. Grunewaldklinik, Berlin, German