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Diagnosis and interpretation of testing for cat scratch disease

Nasim Khalfe1, Doris Lin2

  • 1Baylor College of Medicine, Houston, Texas.

Proceedings (Baylor University. Medical Center)
|December 31, 2021
PubMed

Insights

Cat scratch disease (CSD) diagnosis can be challenging. This case highlights a positive serology despite a negative PCR test for Bartonella henselae, emphasizing diagnostic complexities.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Immunology

Background:

  • Cat scratch disease (CSD) is an infectious illness caused by Bartonella henselae.
  • Diagnosis relies on multiple clinical and laboratory criteria, as no gold standard exists.
  • Bartonella henselae is a Gram-negative bacterium primarily transmitted through infected cat scratches or bites.

Observation:

  • A 44-year-old woman with multiple cats presented with a painful left inguinal mass.
  • Imaging revealed splenic lesions suggestive of an infectious or neoplastic process.
  • The patient exhibited positive serology for Bartonella henselae.

Findings:

  • Polymerase chain reaction (PCR) testing for Bartonella henselae was negative.
  • Despite negative PCR, clinical presentation and positive serology supported a diagnosis of CSD.
  • This case underscores the limitations of individual diagnostic tests for CSD.

Implications:

  • Clinicians must consider a combination of factors for accurate CSD diagnosis.
  • Further research may be needed to improve diagnostic sensitivity and specificity.
  • Understanding atypical presentations is crucial for effective patient management.

Keywords:
Bartonella henselaecat scratch diseasepolymerase chain reaction

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