ISOLATION OF ROCHALIMAEA SPECIES FROM CUTANEOUS AND OSSEOUS LESIONS OF BACILLARY ANGIOMATOSIS
ISOLATION OF ROCHALIMAEA SPECIES FROM CUTANEOUS AND OSSEOUS LESIONS OF BACILLARY ANGIOMATOSIS
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DOI：
10.1056/nejm199212033272303
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发表时间：
1992-12-03
影响因子：
158.5
通讯作者：
TAPPERO, JW
中科院分区：
文献类型：
--
作者：
KOEHLER, JE;QUINN, FD;TAPPERO, JW
背景。杆菌性血管瘤病的特征是血管病变，通常发生在感染人类免疫缺陷病毒（HIV）的患者中。一种新描述的革兰氏阴性生物体，Rochalimaea henselae，已与皮肤杆菌性血管瘤病相关，但尚未从皮肤组织中直接分离和培养任何生物体。方法。我们使用两种方法从四名患有提示杆菌性血管瘤病的皮肤病变的艾滋病毒感染者中分离感染细菌：用真核组织培养单层培养和将均质组织直接铺板到琼脂上。采用裂解-离心法培养患者的血液。通过对聚合酶链式反应扩增的全部或部分 16S 核糖体 RNA 基因进行测序来鉴定从皮肤和血液中回收的分离物。结果。 R. quintana，历史上被称为战壕热病原体，在用单层内皮细胞培养组织匀浆后，从三名患者的皮肤损伤中分离出来；从一名患者的皮肤病变中分离出汉赛罗氏菌。在两名患者的皮肤组织和血液中均分离到了 R. quintana。在一名患者中，它也从骨头中分离出来。结论。在杆菌性血管瘤病中，可以从皮肤病变或血液中分离出两种罗查利马菌（R. quintana 或 R. henselae）中的任一种，这提供了另一种诊断方法。
Background. Bacillary angiomatosis is characterized by vascular lesions, which occur usually in patients infected with the human immunodeficiency virus (HIV). A newly described gram-negative organism, Rochalimaea henselae, has been associated with cutaneous bacillary angiomatosis, but no organism has been isolated and cultivated directly from cutaneous tissue.Methods. We used two methods to isolate the infecting bacterium from four HIV-infected patients with cutaneous lesions suggestive of bacillary angiomatosis: cultivation with eukaryotic tissue-culture monolayers and direct plating of homogenized tissue onto agar. The patients' blood was cultured with the lysis-centrifugation method. Isolates recovered from skin and blood were identified by sequencing all or part of the 16S ribosomal RNA gene amplified with the polymerase chain reaction.Results. R. quintana, historically known as the agent of trench fever, was isolated from cutaneous lesions in three patients, after tissue homogenates were cultivated with endothelial-cell monolayers; R. henselae was isolated from a cutaneous lesion in one patient. In two patients, R. quintana was isolated from both cutaneous tissue and blood; in one patient it was also isolated from bone.Conclusions. In bacillary angiomatosis, either of two species of rochalimaea - R. quintana or R. henselae - can be isolated from cutaneous lesions or blood, providing an additional method of diagnosis.