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Bacteria and Diseases of Unknown Cause

Martin J. Blaser, MD
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Vanderbilt University School of Medicine, Nashville, TN 37232-2605 Requests for Reprints: Martin J. Blaser, MD, Division of Infectious Diseases, Vanderbilt University School of Medicine, A-3310 Medical Center North, Nashville, TN 37232-2605.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1994;121(2):144-145. doi:10.7326/0003-4819-121-2-199407150-00013
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In recent years, many diseases for which the cause was unknown have been shown to be due to bacteria. These include Legionnaire disease (Legionella species) [1], cat scratch disease (Rochalimaea species) [2], the hemolytic-uremic syndrome (Escherichia coli strains, such as O157:H7, producing Shiga-like toxins) [3], peptic ulcer disease (Helicobacter pylori) [4], and a form of chronic arthritis resembling rheumatoid arthritis (Borrelia burgdorferi) [5], among others. Physicians had thought that these disorders were caused by autoimmune phenomena (the hemolytic-uremic syndrome, for example), metabolic processes (peptic ulceration), or viruses [cat scratch disease], and it is instructive to consider why recognition of bacterial causation was delayed. The reasons may be classified as follows: 1) fastidious growth characteristics of the causative bacteria; 2) absence of defined bacterial properties; 3) low bacterial concentrations; 4) uncommon sequelae of common infections; and 5) the power of dogma.



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