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Jordan W. Tappero, MD, MPH; Jane E. Koehler, MD
University of California, San Francisco

JAMA. 1991;266(14):1938-1939.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—We found the article by Dr Holley¹ on successful ciprofloxacin treatment of cat-scratch disease (CSD) to be very interesting. However, we believe that it is important to make a distinction between the diagnosis and treatment of CSD and the disease bacillary angiomatosis (BA), most significantly because we have identified four immunocompromised patients with BA who did not appear to respond to ciprofloxacin treatment.

The five patients treated by Holley were apparently immunocompetent and had classic CSD (although no organisms were demonstrated). The author queries whether ciprofloxacin might prove effective and curative in immunocompromised patients, and briefly comments on antibiotic therapies reported in the literature, although several of these cases had skin lesions representative of BA in immunocompromised patients.^2,3 Our four patients with biopsyproven BA, summarized in the Table, either developed BA while taking ciprofloxacin (patient 1) or failed to show any improvement during a 6 . . . [Full Text PDF of this Article]

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