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Cat scratch disease in Greece
T Karpathios1, C Golphinos, P Psychou
1Second Department of Paediatrics, P and A Kyriakou Children's Hospital, Athens, Greece.
Insights
Indirect fluorescent antibody testing accurately diagnosed cat scratch disease in children. This Bartonella henselae antibody test is a valuable tool for confirming the infection in clinical settings.
Area of Science:
- Infectious Diseases
- Immunology
- Pediatrics
Background:
- Cat scratch disease (CSD) is a bacterial infection caused by Bartonella henselae.
- Diagnosis can be challenging, often relying on clinical presentation and serological tests.
Purpose of the Study:
- To evaluate the utility of indirect fluorescent antibody (IFA) testing for diagnosing Bartonella henselae, B. quintana, and B. elizabethae infections in children with suspected CSD.
- To assess the accuracy of clinical suspicion in diagnosing CSD in a pediatric outpatient setting.
Main Methods:
- An indirect fluorescent antibody (IFA) test was performed on serum samples from 18 children with suspected CSD.
- Samples were collected at admission, 15 days, and 6 months.
- Diagnosis was confirmed by seroconversion, a fourfold change in antibody titer, or a single high antibody titer (>128).
Main Results:
- Diagnosis was confirmed in 15 out of 18 patients (83%).
- Seroconversion or a fourfold antibody titer change to B. henselae confirmed diagnosis in 12 patients.
- Three patients had a single high antibody titer (>128).
- Common clinical manifestations included lymphadenopathy, with other reported symptoms like erythema nodosum, osteomyelitis, hepatitis, transverse myelitis, and granulomata.
Conclusions:
- Clinical suspicion of CSD in a pediatric outpatient setting is highly accurate.
- Indirect fluorescent antibody (IFA) testing for Bartonella henselae is a useful and effective diagnostic tool for confirming CSD.
Abstract:
An indirect fluorescent antibody test for Bartonella henselae, B quintana, and B elizabethae was performed in all 18 children who presented to our paediatric outpatient clinic with cat scratch disease over a six year period. Serum samples were taken on admission, after 15 days, and after six months. Diagnosis was confirmed in 15 patients (83%) and was based on seroconversion or a fourfold change of the antibody titre to B henselae in 12 patients and on a single high titre (> 128) in three patients. Lymphadenopathy was present in all patients, erythema nodosum in one, osteomyelitis in one, hepatitis in one, transverse myelitis in one, and liver or spleen granulomata, or both, in three patients. Cat scratch disease developed in autumn or winter in 12 patients. All had a history of physical contact with a cat. Our study shows that our clinical suspicion was accurate in the diagnosis of cat scratch disease in a high percentage of patients presenting to a hospital and that indirect fluorescent antibody testing for B henselae is a useful diagnostic tool.