Sunday, December 31, 2017

FLU SHOT RESEARCH NOT GOOD

Friday, December 29, 2017

Japans Secret Weapons My take

 
   
         While most of my time is spent on suppressing so called Lyme disease, I find myself at times intrigued in the whys of a government or co-governments that would create such a horrific bio-weapon.

      Trying to keep this a short introduction I can only surmise the balloons that landed on the western USA from Japan (WW2) most likely were filled with bio-weapons, not the tiny bombs that killed a few family members as told to us. Simply a bio-weapons test on delivery methods.

         I write these points for you to open your mind to the evil in this world. Intellectually provoking, possibly prodding you  to investigate and enlighten yourself to save others from our own unwarranted trajectory to be cast a life taken away, maybe not technically a murder but a fate much worse. The life of DISABILITY submersed  in shame and helplessness. A life removed of the ability to achieve ones potential, to provide for ones family, to add to society, the ability to join in your child's physical and some what physiological growth due to absence of the ability to physically to be there. The Simple act of playing ball is taken away, does saying maybe tomorrow honey ring true for you. For my child this disease seems to be a disease of attrition, a plaque of sorts.

          In a few days they will auction off our home. It is a huge shock to ones physic but endured by tens of thousands. My heart ails for my young daughter she loves this home. Another being harmed by the physiological effects of a bio-weapon. A gross weapon secretly refined, willfully hidden by our governments insurmountable mound of lies, aided by multiple surrogates.  Look up McSWEEGAN, , STEERE, BARRBOUR, WORMSER and BARABRA JOHNSON
     
          Comprehending the thought process of an individual involved in the research of bio-warfare weapon is far above my intellectual knowledge of a devastating catastrophic environmental impact on every living creature. As a means of defense against ones nation renders the entire use of such weapons completely implausible. Implausible unless one has the ability to render the bacteria, germ, gas or what ever noneffective against ones own nation. One would need to use a form of immunization  on every living creature in and on your allies continent at the very least if indeed you intended to maintain one. My intuition tells me this is simply impossible to accomplish, not failing to mention the very real possibility of continuing the immunization or a vaccine or cleansing, what ever, forever. At first there would be the triggering of an instant ban of all trade with all uncontaminated or inoculated nations. Further more the elimination of all bird species as a safe guard. Migratory birds would need to be exterminated immediately out of fear by the uncontaminated nations etc, etc, etc. More likely all birds, air currents would transmit the weapon at the utmost speed. The later the more the insanity comes to attrition.
     
         These so called brilliant scientists could not for see the sheer lunacy of such endeavors. We know operation PAPER CLIP was probably nothing more than  a will give you life or you get death kinda deal for the GERMANS but what of the JAPANESE SCIENTIST, I'm betting the same. Bring me the best of the best of mass destruction and we accept you with open arms and the best facilities and unlimited funds. How could they not see the futility in such endeavors. Ft. Dietrich under the guess of a cancer research center is the home of this insanity. The home of the magic EIGHT BALL, really just a way to test their new bio-weapon aerosols.  A trailer for the documentary ( https://vimeo.com/7165595 ).
       
          After reading the book Japans secret weapon I believe the were the first in this field of research. It's fairly well documented the Chinese and Koreans were their first targets for many years as they refined acceptable weapons. It appears the island of Hawaii was targeted before Pearl Harbor also taken from the book below. Remember the Lyme of today was first named RELAPSING FEVER.

          Imagine their over whelming astonishment at discovering they could grow spirochetes into a dense crystal then grind them into micro particles to be used as an aerosol. Then the discovery that one micro particle can regenerate to a mature spirochete. Ecstasy must have ran rapid threw the laboratory. Truly mans greatest accomplishment to date, the ultimate weapon, the world is ours.


JAPAN"S SECRET WEAPON BY BARCLAY NEWMAN

             


                                                A FEW PAGES MORE



Scientist Admits he used Fraud to Discredit Advanced Laboratory ...

https://groups.google.com/d/topic/sci.med.diseases.lyme/AsUhoBMSRDs

Aug 28, 2013 - Dr Sapi found that a large number of her US patient blood samples contained Borrelia which were closely matched to a Japanese strain of Borrelia garinii called HP1

      If you care to see a USA specialist McSweegan admit to it being a weapon read about it in TRUTH CURES. This organization sole purpose is to PROSECUTE THE CRIMINALS of DEARBORN a conference to alter the true diagnosis of Lyme Disease.
                                                               


       I just saw this today a week after I started writing this piece 

https://www.anonymous-feed.com/north-

korean-soldier



HISTORY OF CHEMICAL- BIO WEAPONS

https://www.dailykos.com/stories/2013/9/6/1236340/-History-of-Chemical-Biological-Arms-Race-Chapter-One

        

Thursday, December 21, 2017

LYME is OspA is Pam3Cys, and is a FUNGAL SHEDDER and THEY KNOW IT











So, Thimerosal was invented to prevent LYMErix in a vial. LYMErix is OspA is Pam3Cys, and is FUNGAL, because it is a TLR2/1 agonist, and the majority of the antigens handled by TLR2/1 are triacyl lipoproteins which mainly come from fungal pathogens or fungal-antigen-shedding spirochetes. I am not making this up. This is how lame the HHS.gov is.
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Why is the growth of fungal antigens together in a vial with live, allegedly attenuated viruses bad?
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Because when you inject live viruses together with immune suppressing fungal antigens (TLR2/TLR1- agonists), you’re not going to get a proper immune response (antibodies) against these live viruses, and then they can revert to “the wild type” – the aggressive disease type -, or even not. They can be virulent (cause damage) as they are, in the allegedly “attenuated” form.
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Who says this?
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None other than Johns Hopkins’ Paul Auwaerter, one of the banes of all the sick and disabled, especially with those with tick bite sepsis, or are among the >/= 50% of people who never recover from “Lyme.”
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Dont believe me?
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Use your browsers search feature to look for his name and the things he has done and published, here:
http://www.actionlyme.org/2017_Criminal_Charges_Sheets_All.…
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But I cant force you to, can I? If you were to do that – search for Auwarter’s journal articles in the charge sheets, it would be of your own will. You’d be an unlazy person willing to go the extra step. You’d be a person who is aware that you cant see the world on a “mobile device,” and you certainly cant blog from one….
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Altered virulence of vaccine strains of measles virus after prolonged replication in human tissue.
Valsamakis A1, Auwaerter PG, Rima BK, Kaneshima H, Griffin DE.
“…Our data suggest that the adverse outcomes associated with immunization of patients suffering from congenital and acquired immunodeficiency syndromes are due to the emergence of an MV strain with increased virulence in a host unable to mount a sufficient immune response to clear the originally inoculated vaccine virus. This situation is mimicked in the SCID-hu mouse. Sequence analyses of pMor-1 H and M and other isolates derived from immunodeficient patients demonstrate that these human tissue-passaged vaccine isolates are highly related to parent vaccine strains (1, 15).
“…However, fatal infections have been documented in immunodeficient children vaccinated with these strains (1, 12, 14, 15). The symptoms of infection occur many months after immunization, and the viruses isolated are similar to the original LA vaccine (1, 15), suggesting that in the absence of an effective host immune response, persistent infection with the vaccine strain can lead to fatal disease. Viruses isolated from these children could potentially represent virulent revertants of the original LA vaccine.”
https://www.ncbi.nlm.nih.gov/pubmed/10482633
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Well, well, well, doesn’t that sound exactly like what they went after Andrew Wakefield for saying?
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There’s more from little Pauly Gisbert Auwaerter (in the charge sheets)…
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Paul Auwaerter Also Says (about how measles causes immunosuppression and that the fatal brain infections can come from the vaccines)…
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“Increased virulence of vaccine strains isolated from immunocompromised infants with fatal infections was not evident.”
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J Infect Dis. 1999 Oct;180(4):950-8.
Measles virus infection in rhesus macaques: altered immune responses and comparison of the virulence of six different virus strains.
Auwaerter PG1, Rota PA, Elkins WR, Adams RJ, DeLozier T, Shi Y, Bellini WJ, Murphy BR, Griffin DE.
“Measles remains a major cause of childhood mortality, with questions about virus virulence and pathogenesis still requiring answers. Rhesus macaques were infected with 5 different culture-adapted strains of measles virus, including 2 from patients with progressive vaccine-induced disease, and a sixth nonculture-adapted strain, Bilthoven. All caused infection detectable by reverse transcriptasepolymerase chain reaction and induction of antibody. Chicago-1 and Bilthoven induced viremias detectable by leukocyte cocultivation. Bilthoven induced Koplik’s spots, conjunctivitis, and rash.
Lymphopenia and depressed interleukin (IL)-2 production were followed by monocytosis and eosinophilia. All monkeys, including 41 involved in a primate facility outbreak, showed suppressed responses to phytohemagglutinin. As the rash resolved production of IL-2, IL-1beta, tumor necrosis factor-alpha, IL-6, and IL-5 mRNA increased. Monkeys are useful for studies of measles immunopathogenesis, but virus strains must be carefully chosen. Increased virulence of vaccine strains isolated from immunocompromised infants with fatal infections was not evident.
”Measles is an important human disease that causes the death of ∼1,000,000 children [a million, really, Paul?- kmd] each year. Most of these deaths are due to secondary infections [1] {{sound familiar?- it should, that is what happens in Lyme or tick-bite-sepsis- kmd}}.
“This increase in susceptibility to other pathogens is associated with a well-documented measles-induced immunosuppression [2]. This suppression of immune responses is incompletely understood and is probably multi-factorial: it
is likely that different mechanisms are of primary importance in early and late phases of infection. Human studies of necessity focus on the time of the appearance of the rash and thereafter, because that is when measles is recognized clinically. Studies in primates offer the opportunity to look at all phases of infection.
”Many of the deaths associated with secondary infection could be prevented by more widespread application of measles immunization. The vaccine against measles is a live attenuated virus with an impressive record of efficacy and safety, although suppression of immune responses is often detectable after immunization [3]. …”
https://www.ncbi.nlm.nih.gov/pubmed/10479117
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So, the vaccine strains, allegedly rendered un-virulent, are, in fact, virulent. Thanks, Paul, we will let everyone know.
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And so, the measles virus, itself, injected into the children with numerous other active viruses at the same time, CAN BE the cause of the immunosuppression and the resultant activation of those other vaccine viruses. Check. Good to know.
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So, inject kids first, then find out of they were immunosuppressed afterwards (or because one of the 3, at least, measles can cause this immunosuppression on its own) – by the results, the brain damage. All these MMR viruses are neurotropic and the models of this “neurodevelopmental brain damage” from these live viruses are borna virus or picornavirus (see that also in the charge sheets, by Stanley Plotkin, another Lyme dick).
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Also, Auwaerter says: “This suppression of immune responses is incompletely understood and is probably multi-factorial: it is likely that different mechanisms are of primary importance in early and late phases of infection. Human studies of necessity focus on the time of the appearance of the rash and thereafter, because that is when measles is recognized clinically.”
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So, inject 3 or more live, allegedly attenuated viruses into infants with immature immune systems, some of which are known to cause immunosuppression, and we know what happens in immunosuppression – reactivated viruses.
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Auwaerter is also suggesting there is the non-spots form of the disease, or a non-inflammatory form of the disease. The Lyme criminals say “you cannot have a disease without inflammation,” or that “there is no disease other than autoimmune,” when we know the opposite is the most damaging outcome: live
viruses and infections without immunity. And go ahead on your own and google “reverts to wild type” or just “wild type.”
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Why do they say this about Lyme – that “you cant have a disease unless it is inflammatory or autoimmune (see this Shapiro quote on this in the charge sheets) ?
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Because as you have just seen, that is how the Autism Vaccines work. And there is more such scientific evidence in the charge sheets. The Occam’s Razor charge sheet and the Common Mechanisms charge sheet are related. They’re basically all one continuous charge, and they contain mainly evidence by the criminals of Lyme and CFIDS and Vaccines.
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How are they going to defend themselves in court regarding saying something 180 degrees from their public statements in the scientific literature, especially over EVERY aspect of this? How can they say they were wrong about biomarkers of disease or their general statements about vaccines or how Lyme caused immunosuppression or that they reported that the Dearborn case definition only detected 15% of the cases, and then said publicly, that all else was NOT-LYME?
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But we dont have time to fuss and we cant dumb this down to a level or a class of people who would not even bother to use a dictionary or Wikipedia, or the personality disordered. (Yes, ticks can bite all kinds of people, not just people with the genetic/NF1-related kind of Autism, or normal people or smart people or lazy people or dumb people or handsome people or ugly people or the severely vain or delusional.)
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We have to reach a target audience somewhere between the lay person and the actual scientists we’re quoting in the charge sheets. We cant talk baby talk to any potential young, untarnished physicians who have heard nothing about the Lyme Crymes before. We need people who are willing to put a little effort into this, to study the charge sheets, communicate with the rest of the bloggers, ask questions, and be involved in putting an end to the CDC’s crimes on behalf of their future victims.
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If that’s you, please help us out. “No army in the world can defeat an idea whose time has come” – Victor Hugo.
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December 12, 2017 in Recruiting Bloggers/Activists.
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Recent Posts:
“Chronic Lyme:” It’s a Coin Toss
“Chronic Lyme:” It’s a Coin Toss
The fact of the matter is that “chronic Lyme,” the outcome that was eliminated from the case definition at Dearborn in 1994, is tick bite post-sepsis AIDS, an immunosuppression disease. Many different scientific groups agree on this matter, including the crooks who sought to capitalize on our suffering.
Comments to the TBDWG
Comments to the TBDWG
It’s funny; if I didn’t trust the government I might think that Dr. Dixon and the other bioweapons dabblers in the group were appointed for nefarious reasons.
World Lyme-AIDS Day
It’s World AIDS Day this Friday, December 1, and at the risk of seeming to diminish the struggles of the HIV/AIDS community, I can’t help feeling envious of the vindication that they have achieved. Lyme victims, I’m sure, will understand this sentiment. Those who have not been affected by Lyme, however, are fully expected to […]
wormser doesn’t even deserve a seat at the kids’ table
Gary Wormser is known to despise patients, anyone who advocates for them, and especially the ones who are outspoken about his involvement in the 1994 Dearborn fraud where the ALDF/CDC cabal threw out the sickest cases from the disease definition.
Pat Smith. Really?
Clearly this woman is not seeking any real answers for the victims she claims to serve, because she knows what the disease is and yet refuses to talk about it. She proved as much by claiming to have gotten LYMErix off the market. Now she’s sitting on a DoD panel and doling out federal grants. TO WHOM IS SHE GRANTING RESEARCH DOLLARS?

THE TRUTH ABOUT MERCURY FILLINGS

Sunday, December 17, 2017

What Nutrients Are Found in Colostrum?





What Nutrients Are Found in Colostrum?

What Nutrients Are Found in Colostrum?


Colostrum is the “first food of life,” and it helps promote newborn growth and development. All mammalian mothers produce colostrum in the first few days before and after the birth of their young. Colostrum contains a plethora of powerful substances that ensure these newborns can get the nutrients they need to fight off disease and infection while helping to mature the gastrointestinal tract. Animal babies will die if they do not receive colostrum. Human babies can survive without colostrum, but they are generally at a developmental disadvantage and are more susceptible to infectious illnesses in comparison to those who receive colostrum.
Although many people link colostrum exclusively to newborn growth and development, it is important to note that the benefits of bovine colostrum supplementation extend to individuals young and old. In fact, bovine colostrum contains many essential nutrients that help people shut down intestinal permeability, the root cause of most autoimmune conditions and allergies, as well as prevent and mitigate infection.
Intestinal permeability, also referred to as a leaky gut, results in larger-than-average spaces between the cells in the gut wall. The normally tight junctions between the cells loosen and become “less tight.” Of note, the gut wall is only ONE cell thick, so it’s easy to understand how easily the gut can become leaky. When these spaces form, they enable undigested food particles, viruses, bacteria, fungi, chemicals, and other toxic materials to enter the bloodstream. As a result, these toxic materials can cause inflammation within the body when the immune system reacts to these “foreign” substances.

Ultimately, colostrum helps heal a leaky gut, thanks in large part to its vast array of immune-modulating components and growth factors. Some immune-modulating components destroy pathogenic gut bacteria that otherwise “eats away” at the gut wall. This process allows the body to naturally eliminate the pathogenic bacteria through a bowel movement. Other components make the immune system more effective at doing the job it was intended to do – keep us free from infection. Growth factors restore “tightness” to the cellular junctions and prevent substances from crossing over into the bloodstream. And once a leaky gut is healed, the body can work normally to repair tissue that may have been damaged by years or decades of leaky gut and widespread inflammation.
The powerful components in colostrum can make a world of difference for men, women, children, and even pets. Now, let’s take a look at the key components found in colostrum, as well as how these components support optimal gut and immune health.
Immune-Modulating Components 
Colostrum contains a variety of components that help boost, balance, and maintain the immune function, such as:
  • Cytokines: Colostrum features interleukins, interferon, and lymphokines, chemicals that are involved in intercellular communication, antiviral and anti-tumor activity, and regulation and intensity of immune response. Cytokines help increase T-cell activity and drive production of immunoglobulins. In particular, the interleukin-10 in colostrum contains a potent anti-inflammatory agent that has been shown to have a significant pain-relieving effect.
  • Glycoproteins: Glycoproteins refer to proteins with sugar attached to them. They help safeguard the immune and growth factors in colostrum against destruction by the digestive juices in the stomach and intestinal tract.
  • Immunoglobulins/Antibodies: Colostrum is rich in immunoglobulins, antibodies that help neutralize pathogenic bacteria and viruses. High-quality colostrum contains at least 18% immunoglobulins, and these antibodies help the immune system combat viral infections, bacterial infections, allergies, fungi, and yeast. Colostrum also contains specific antibodies that help the body fight off the effects of E. coli, salmonella, and other food-borne pathogens.
  • Lactalbumin: Commonly referred to as “whey protein,” lactalbumin is found in mammalian milk. Lactalbumin possesses antiviral, anti-apoptotic, and anti-tumor properties and helps improve immune response. Research shows that lactalbumin helps the body mitigate the effects of cancer and viruses. Lactalbumin also may help increase the brain’s serotonin activity, reduce cortisol concentration, and improve a person’s mood.
  • Lactoferrin: As an iron-binding protein with antiviral, antibacterial, and anti-inflammatory properties, lactoferrin has been used to help treat diseases such as cancer, HIV, and herpes. When lactoferrin binds to iron, it takes away the iron that pathogens would otherwise use to help replicate themselves.
  • Lysozyme: Lysozyme is an antimicrobial enzyme that is capable of breaking the chemical bonds that form the outer cell wall of bacteria. It helps protect the body against bacterial infections and eliminates bacteria on contact.
  • Proline-Rich Polypeptides (PRPs): Also known as “colostrinin,” PRPs help manage the immune response by either turning up an underactive immune system or turning down an overactive one. They help regulate the thymus gland (the body’s central command for the immune system). 
Colostrum’s immune-modulating components have been shown to help people overcome the effects of leaky gut syndrome(LGS). They help promote the re-colonization of the bowel by friendly bacteria to assist in food digestion, eliminate waste, produce B vitamins, and minimize the danger of gut-based infections.
Since the antibodies in colostrum are so important to infection prevention and control, it’s worth taking a more detailed look at what they are and what they do. Antibodies are protective proteins produced by the immune system. They typically form in response to antigens, foreign substances that can otherwise damage immune function. Antibodies will recognize antigens, latch on to them, and remove them from the body. By doing so, antibodies help reduce the risk of disease-causing organisms from entering the bloodstream (via a leaky gut).
Antibodies also provide local protection of the GI tract from gut infections, specifically enteric infectious diseases. Studies have revealed various bovine colostrum antibodies may be effective to combat both enteropathic and enterotoxic E. coli, Cryptosporidium parvum, rotavirus, and Shigella flexneri. In many parts of the developing world, gut-based infections are cause of death due to massive diarrhea and dehydration. Also, research indicates a high percentage of the antibodies and immunoglobulins present in colostrum remain in the intestinal tract and attack disease-causing organisms before they can enter the bloodstream. The remaining antibodies are absorbed by the body and distributed throughout it to assist in internal defense processes. This combination of actions helps make colostrum effective as a natural oral supplement, and may reduce the need for dangerous oral antibiotics. 
Growth Factors  in Bovine Colostrum
Studies have indicated that the growth factors in bovine colostrum are virtually identical to those found in human colostrum. Bovine colostrum’s growth factors have been shown to support normal growth, as well as help regenerate and accelerate the repair of aged or injured muscle, skin collagen, bone, cartilage, and nerve tissues.

Growth Factors in Bovine Colostrum
The growth factors in bovine colostrum include:
  • Epithelial Growth Factor (EGF): EGF plays a key role in helping people protect and maintain the skin and stimulate tissue repair and skin growth.
  • Insulin-Like Growth Factors (IGF-I and IGF-II): IGF-I and IGF-II are the most prominent growth factors in colostrum and affect how the body uses fat, protein, and sugar. IGF-I has been shown to promote protein synthesis, leading to an increase in muscle mass and
    a decrease in fat tissue. Furthermore, IGF-I has been proven to stimulate the repair and growth of DNA and RNA, making it a powerful anti-aging substance.
  • Platelet-Derived Growth Factor (PDGF): PDGF helps with cell division in connective tissue, smooth muscle, and fibroblasts and promotes neuron survival and regeneration.
  • Transforming Growth Factors A & B (TGF A & TGF B): TGF stimulates the proliferation of cells in connective tissue and supports bone and cartilage development. It also helps repair tissue and supports the growth and development of the gut lining.
Additionally, bovine colostrum’s growth factors help stimulate the body to burn fat for fuel instead of the body’s own muscle tissue in times of fasting (diet), leading to the growth and development of lean muscle. These growth factors can even be used as a topical application to aid in the healing of burns and injuries and rejuvenate the skin. 
Today, Colostrum-LD® represents a top choice among powdered bovine colostrum supplements Not only does it contain verified quantities of the most health-enhancing components (immune-modulators and growth factors), Colostrum-LD® is the only clinically proven substance that helps combat LGS. It also contains a liposomal delivery (LD) system that helps make colostrum’s healing components more bioavailable than other colostrum products.
When it comes to colostrum supplementation, it pays to choose a proven product. Colostrum-LD® has 25 years of research behind it, and offers a superior choice for people of all ages. Colostrum-LD helps people get the nutrients they need to optimize immune function, heal the GI and stomach lining, eliminate harmful pathogens, and much more.
http://www.sovereignlaboratories.com/blog/components-found-colostrum/

Friday, December 15, 2017

DIET SONG HILARIOUS

Cat Scratch Disease Presenting as Breast Cancer: A Report of an Unusual Case





1San Giuseppe Moscati Hospital of Avellino, General Surgery and Breast Unit, Italy
2Federico II Universitary Hospital of Naples, General Surgery, Italy
3Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
4Santa Maria alle Scotte University Hospital of Siena, Hematology, Italy
5San Giuseppe Moscati Hospital of Avellino, Radiology, Italy
6San Giuseppe Moscati Hospital of Avellino, Pathology, Italy
Received 8 January 2013; Accepted 5 February 2013
Academic Editors: A. Goodman, P. F. Lenehan, and J. I. Mayordomo
Copyright © 2013 Carlo Iannace et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Benign lymphoreticulosis (cat scratch disease, CSD) may have a clinical course that varies from the most common lymphadenitis localized in the site of inoculation, preceded by the typical “primary lesion,” to a context of severe systemic involvement. Among these uncommon clinical aspects, there is mammarian granulomatous lymphadenitis which may appear as a mastitis or a solitary intraparenchymal mass, giving the impression of a breast tumor. In these cases, intensive clinical, instrumental, and laboratory investigations are necessary to exclude malignancy. Because of its rarity, in equivocal cases, it is reasonable to use surgical excision for accurate histological examination. We report a case of CSD of the breast in a 59-year-old woman, analyzing the clinical, histopathological, and instrumental appearance and also performing a literature review.

1. Introduction

Benign lymphoreticulosis (cat scratch disease, CSD) is a zoonotic disease from Bartonella henselae, which usually manifests as a localized granulomatous lymphadenopathy near the site of inoculation after a cat scratch or other pet’s one. In a minority of cases, it can have a severe systemic involvement with splenitis, mediastinitis, and encephalitis [13].
The mammarian localization is very uncommon, sporadic reports are given in the literature [412]. During the clinical and instrumental investigations, it may appear as a solitary intraglandular mass mimicking inflammatory breast cancer.
We report an unusual case of CSD with breast localization in a 59-year-old woman, describing the clinical, histopathological, and instrumental appearance, also performing a literature review.

2. Case Report

A 59-year-old white woman, without having significant medical or surgical history, having familiarity with breast cancer, and not undergoing regular mammographic screening, shows the occurrence of palpable mass in the upper outer quadrant of her right breast accompanied by pain fever.
On physical examination, we detect the presence of a nodule of the right upper outer quadrant. This nodule has a maximum diameter of about 2 cm, it is painless, fixed on the deep layers, and hard. Moreover, palpable lymph nodes in the ipsilateral axilla and the presence of a whitish skin lesion, slightly elevated (diameter 0,5 cm) in the intermammillar region 2 cm below the angle of Luis, are observed.
The mammogram showed a radiopaque nodule about 20 mm, with irregular and spiculated margins (Figure 1).
507504.fig.001
Figure 1: Mid-lateral mammogram of the right breast shown in the upper outer quadrant in a radiopaque mass with margins irregular and speculated.
On ultrasonography mass appears a hypoechoic with irregular margins, with dimensions of 12,5 × 12,5 mm, highly suggestive of heteroplastic lesion; furthermore, enlarged lymph nodes in the contralateral axilla (diameter 35 mm) with vascular poles are identified (Figure 2). On MRI, the lesion shows thin marginal spiculature and an early marked increase in the signal after contrast with a peak at the second minute, marking itself compatible with focality type 4 BIRADS (BIRADS was developed by the American College of Radiologists as a standard of comparison for rating mammograms and breast ultrasound images. It sets up a classification for the level of suspicion (LOS)—the possibility of breast cancer. BIRADS 4 means that findings do not definitely look like cancer but could be cancer. The radiologist is concerned enough to recommend a biopsy) (Figures 3(a) and 3(b)).
507504.fig.002
Figure 2: Ultrasonography of the left axillary shows an enlarged lymph node of about 35 mm with vascular poles at color-Doppler.
fig3
Figure 3: ROI on the lesion and curve  type 3 (malignant).
It runs fine needle aspiration of bilateral axillary lymphadenopathy; in both cytology smears, it did not detect neoplastic epithelial cells. Laboratory investigations of the values of CEA and CA 15–3 are normal, as well as inflammatory markers and white cell count.
Given the clinical and instrumental impression of malignancy, we proceed to a complete surgical excision of the mass with quadrantectomy, ipsilateral axillary dissection, and a biopsy of contralateral axillary enlarged lymph nodes with an extemporaneous exam, the skin lesion is also removed.
Histologically, the breast lesion is composed of a granulomatous and necrotizing inflammation (Figure 4). The granulomas are composed of elements such as histiocytes with occasional multinucleated giant cells, extensive inflammatory infiltration externally, and extensive areas of confluent necrosis. A similar picture is observed on both axillary lymph nodes and skin lesion. The colors and culture test for fungi, typical and atypical mycobacteria, and immunohistochemistry for toxoplasmosis are all negative. The Warthin-Starry silver staining, specific for Barthonella henselae is negative.
507504.fig.004
Figure 4: Characteristic suppurative granulomas and stellate microabscess formation (H and E, ×20).
At a later and a more accurate anamnestic investigation, the patient reveals that he had repeated contact with domestic animals and that he had observed, prior to breast pain, the appearance of a lesion such as an erythematous papule on the chest wall and on the site of a skin lesion removed surgically. After five weeks from surgery, the specific serological test is positive for Bartonella henselae.
Upon this positivity, the patient is subjected to azithromycin for three weeks. After five weeks, posttreatment shows a subcutaneous swelling on the right arm that on ultrasound has mixed echogenicity, similar to abscess. This swelling subsides spontaneously; the chest TC shows no active pleuropulmonary disease, and abdominal ultrasound excludes hepatosplenic involvement. The patient underwent clinical and instrumental followup every six months.

3. Discussion

In the classic form of CSD, typical of immunocompetent individuals, after 3–10 days from cutaneous inoculation it develops the characteristic of “primary lesion”, that progresses through the stages of vesicle and erythematous papule, resolving within 1–3 weeks. This is associated with lymphadenopathy in one or more of the injected satellite stations.
The most frequently involved lymph nodes are the anterior cervical, preauricular, supraclavicular, axillary, epitrochlear, inguinal, and femoral [138].
In immunocompromised patients, the infection may progress to a systemic form, with involvement of internal organs. A microscopic evaluation of the involved lymph nodes reveals the presence of fibrosis of the capsule and subcapsular sinus, follicular hyperplasia, hypertrophy of the germinal centers, and a typical granulomatous reaction with central necrosis in 3 of 4 patients [6].
Our patient showed a picture of a lesion pathologically similar. The diagnosis is made in presence of three of the five following criteria: (1) a history of contact with animals and finding a scratch or a cutaneous “primary lesion”; (2) the presence of regional lymphadenopathy; (3) the exclusion of other possible causes of lymphadenopathy by serological and/or culture test; (4) a positive intradermal test with specific antigen; (5) the typical histopathological changes in lymph nodes examined.
If typical pleomorphic bacilli are demonstrated by the Warthin-Starry stain, the diagnosis is made also with the positivity of only one of the criteria outlined earlier [2]. Using this staining of formalin-fixed tissues, you can increase the visibility of microorganism through the deposition of silver [1314]. However, in early lesions they may not appear [9].
In these cases, the search by PCR of microbial DNA may still be positive [15]. Usually, antimicrobial therapy is not required, because the process tends to limit itself. However, a positive response to different antimicrobials is reported in the literature, including azithromycin, which is considered the first-choice drug [916]. The CSD of the breast is really an unusual clinical entity.
Lefkowitz and Wear in 1989 reported the first four cases, being able to identify the characteristic bacilli by Warthin-Starry silver staining [4].
Chess and colleagues are the first to describe the sample obtained by FNAC in the CSD of the breast. Their sample is negative on Warthin-Starry staining; however, they make a diagnosis of CSD by a history of cat scratch and a positive intradermal test [5]. Its important diagnostic role is reported in the literature, especially in patients with peripheral lymphadenopathy and after surgery in patients with breast lesions. The pus aspirated from lymph nodes is used for intradermal injection. In positive cases, the injection of antigen is followed by the appearance of erythema with central swelling at the site of inoculation within 24–48 h. However, this test is not widely practiced for the lack of a standardized preparation [7].
Our report illustrates a truly rare case of CSD localized in the breast, whose clinical and instrumental aspect mimicked that of a breast cancer.
In particular, the results of MRI with a contrast agent has shown a curve  (Figure 3(b)) with rapid wash-in, plateau and the presence of wash-out, then typo 3 (typical of malignant lesions), a compatible morphological appearance, therefore, a score 4 to the classification of BIRADS.
This induced us not to consider the need for a fine needle aspiration of the lesion in the right upper outer quadrant, because we have already considered malignant, but to perform a fine needle aspiration of multiple and bilateral axillary lymphadenopathy. This was negative for neoplastic cells. We proceeded to surgery as described earlier and not to aspirate the intraparenchymal lesion, whose negativity for tumor cells, in disagreement with the clinical and instrumental aspect of malignancy, would induced us, in any way, to take an aggressive approach, such as that of surgical treatment.

4. Conclusion

CSD with mammarian granulomatous lymphadenitis is a very rare event, so it is difficult to consider it in the differential diagnosis of breast nodules. In case of clinical and instrumental doubt, it is reasonable to use a surgical approach to obtain an accurate histologic diagnosis of the lesion’s nature.

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