XXXX in Hawaii: etiology and seroepidemiology.

@entity1 @entity235 @entity281 @entity2711 @entity11102 @entity468 @entity2259
OBJECTIVE: To study the etiology and seroepidemiology of @entity11102 ( @entity11102 ) in Hawaii. METHODS: Blood and fine-needle aspirate (FNA) from the lymph nodes of 39 consecutive @entity1 with clinical @entity11102 were cultured for @entity2711 , and blood samples from index @entity468 , stray @entity468 , and @entity235 were cultured and their sera were tested by indirect fluorescence antibody test for antibodies to @entity2711 and Afipia felis. Sera from age- and sex-matched @entity1 subjects without cat exposure served as controls. RESULTS: Warthin-Starry staining showed positive results in only 4 of 32 FNAs, and @entity2711 was isolated from only one FNA specimen. All of 38 @entity1 who had two or more sera tested had elevated titers of antibody to @entity2711 . Only 1 of 48 @entity1 control sera had antibody to @entity2711 . Of 31 kittens, 21 had positive blood culture results and elevated antibody titers to @entity2711 . Of three adult @entity468 , all had negative blood culture results, but they had serologic evidence of past @entity281 . Of 23 adult stray @entity468 , 18 had elevated titers of antibody to @entity2711 , but in only one was the blood culture result positive. Results of IFA tests were marginally positive for A. felis in 1 of 29 @entity1 with @entity11102 and in one adult stray cat and one @entity235 . CONCLUSIONS: This study shows that the @entity2711 IFA test is both highly sensitive and specific for the detection of @entity281 caused by @entity2711 and for the laboratory diagnosis of @entity11102 , and that FNA is seldom helpful in confirming the diagnosis. We further demonstrated that @entity11102 in Hawaii is due to @entity2711 and that @entity281 is directly linked to the scratch or bite of a kitten. Older @entity468 seldom have @entity2259 but often have serologic evidence of past @entity281 . Our study fails to implicate @entity235 in the epidemiology of @entity11102 in Hawaii, and A. felis was not etiologically implicated in @entity11102 in the @entity1 subjects and animals we studied.
