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J Clin Microbiol. Aug 1997; 35(8): 1931–1937.
PMCID: PMC229879

Pitfalls and fallacies of cat scratch disease serology: evaluation of Bartonella henselae-based indirect fluorescence assay and enzyme-linked immunoassay.

Abstract

The diagnostic value of the detection of immunoglobulin G (IgG) and IgM by Bartonella henselae-based indirect fluorescence assay (IFA) and enzyme-linked immunoassay (EIA) for the diagnosis of cat scratch disease (CSD) was evaluated. The IFA was performed either with B. henselae that was cocultivated for a few hours with Vero cells or with noncocultivated B. henselae as the antigen. Additionally, the performance of a Bartonella PCR hybridization assay based on the 16S rRNA gene was determined and compared with those of the serologic assays. The study group consisted of 45 patients suspected of suffering from CSD by fulfilling one or more of the classical criteria. The specificities of the immunoassays were set at > or = 95% by analysis of sera from 60 healthy blood donors. It is shown that the sensitivities of the IgG assays are very low (40.9% for the IFA with noncocultivated B. henselae as antigen) and that those of the IgM assays are higher (71.4% for the EIA) for patients who fulfilled two or more criteria for CSD. The IgM EIA showed the highest sensitivity: 71.4% in patients with two or more criteria for CSD and 80.6% for patients with a positive Bartonella PCR result. The results indicate that the specificities of both IFA and EIA IgG serologies and the sensitivity of the IFA IgM serology need to be improved. The PCR hybridization assay showed a sensitivity of 86.4% for patients who fulfilled two or more criteria for CSD and 100% for seven patients who fulfilled three or more criteria. The kinetics of IgG and IgM antibody production were studied in 18 patients with CSD on the basis of a positive B. henselae IFA IgM serology. The results indicate that there is no standard course of anti-B. henselae IgG and IgM production in patients with CSD, because some patients produced high levels of both IgG and IgM, others produced only high levels of IgM, and a few patients produced only low levels of antibodies.

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Selected References

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  • Amerein MP, De Briel D, Jaulhac B, Meyer P, Monteil H, Piemont Y. Diagnostic value of the indirect immunofluorescence assay in cat scratch disease with Bartonella henselae and Afipia felis antigens. Clin Diagn Lab Immunol. 1996 Mar;3(2):200–204. [PMC free article] [PubMed]
  • Anderson B, Sims K, Regnery R, Robinson L, Schmidt MJ, Goral S, Hager C, Edwards K. Detection of Rochalimaea henselae DNA in specimens from cat scratch disease patients by PCR. J Clin Microbiol. 1994 Apr;32(4):942–948. [PMC free article] [PubMed]
  • Anderson B, Lu E, Jones D, Regnery R. Characterization of a 17-kilodalton antigen of Bartonella henselae reactive with sera from patients with cat scratch disease. J Clin Microbiol. 1995 Sep;33(9):2358–2365. [PMC free article] [PubMed]
  • Barka NE, Hadfield T, Patnaik M, Schwartzman WA, Peter JB. EIA for detection of Rochalimaea henselae-reactive IgG, IgM, and IgA antibodies in patients with suspected cat-scratch disease. J Infect Dis. 1993 Jun;167(6):1503–1504. [PubMed]
  • Batterman HJ, Peek JA, Loutit JS, Falkow S, Tompkins LS. Bartonella henselae and Bartonella quintana adherence to and entry into cultured human epithelial cells. Infect Immun. 1995 Nov;63(11):4553–4556. [PMC free article] [PubMed]
  • Bergmans AM, Groothedde JW, Schellekens JF, van Embden JD, Ossewaarde JM, Schouls LM. Etiology of cat scratch disease: comparison of polymerase chain reaction detection of Bartonella (formerly Rochalimaea) and Afipia felis DNA with serology and skin tests. J Infect Dis. 1995 Apr;171(4):916–923. [PubMed]
  • Campbell JA. Cat-scratch disease. Pathol Annu. 1977;12(Pt 1):277–292. [PubMed]
  • Dalton MJ, Robinson LE, Cooper J, Regnery RL, Olson JG, Childs JE. Use of Bartonella antigens for serologic diagnosis of cat-scratch disease at a national referral center. Arch Intern Med. 1995 Aug 7;155(15):1670–1676. [PubMed]
  • Demers DM, Bass JW, Vincent JM, Person DA, Noyes DK, Staege CM, Samlaska CP, Lockwood NH, Regnery RL, Anderson BE. Cat-scratch disease in Hawaii: etiology and seroepidemiology. J Pediatr. 1995 Jul;127(1):23–26. [PubMed]
  • Dolan MJ, Wong MT, Regnery RL, Jorgensen JH, Garcia M, Peters J, Drehner D. Syndrome of Rochalimaea henselae adenitis suggesting cat scratch disease. Ann Intern Med. 1993 Mar 1;118(5):331–336. [PubMed]
  • Drancourt M, Mainardi JL, Brouqui P, Vandenesch F, Carta A, Lehnert F, Etienne J, Goldstein F, Acar J, Raoult D. Bartonella (Rochalimaea) quintana endocarditis in three homeless men. N Engl J Med. 1995 Feb 16;332(7):419–423. [PubMed]
  • Drancourt M, Birtles R, Chaumentin G, Vandenesch F, Etienne J, Raoult D. New serotype of Bartonella henselae in endocarditis and cat-scratch disease. Lancet. 1996 Feb 17;347(8999):441–443. [PubMed]
  • English CK, Wear DJ, Margileth AM, Lissner CR, Walsh GP. Cat-scratch disease. Isolation and culture of the bacterial agent. JAMA. 1988 Mar 4;259(9):1347–1352. [PubMed]
  • Hamilton DH, Zangwill KM, Hadler JL, Cartter ML. Cat-scratch disease--Connecticut, 1992-1993. J Infect Dis. 1995 Aug;172(2):570–573. [PubMed]
  • Hollingdale MR, Herrmann JE, Vinson JW. Enzyme immunoassay of antibody to Rochalimaea quintana: diagnosis of trench fever and serologic cross-reactions among other rickettsiae. J Infect Dis. 1978 May;137(5):578–582. [PubMed]
  • Kalter SS, Rodriguez AR, Heberling RL. Cat-scratch disease skin-test antigen preparation. Lancet. 1977 Sep 17;2(8038):606–607. [PubMed]
  • Nadal D, Zbinden R. Serology to Bartonella (Rochalimaea) henselae may replace traditional diagnostic criteria for cat-scratch disease. Eur J Pediatr. 1995 Nov;154(11):906–908. [PubMed]
  • Patnaik M, Peter JB. Cat-scratch disease, Bartonella henselae, and the usefulness of routine serological testing for Afipia felis. Clin Infect Dis. 1995 Oct;21(4):1064–1064. [PubMed]
  • Regnery RL, Olson JG, Perkins BA, Bibb W. Serological response to "Rochalimaea henselae" antigen in suspected cat-scratch disease. Lancet. 1992 Jun 13;339(8807):1443–1445. [PubMed]
  • Szelc-Kelly CM, Goral S, Perez-Perez GI, Perkins BA, Regnery RL, Edwards KM. Serologic responses to Bartonella and Afipia antigens in patients with cat scratch disease. Pediatrics. 1995 Dec;96(6):1137–1142. [PubMed]
  • Zangwill KM, Hamilton DH, Perkins BA, Regnery RL, Plikaytis BD, Hadler JL, Cartter ML, Wenger JD. Cat scratch disease in Connecticut. Epidemiology, risk factors, and evaluation of a new diagnostic test. N Engl J Med. 1993 Jul 1;329(1):8–13. [PubMed]
  • Zbinden R, Höchli M, Nadal D. Intracellular location of Bartonella henselae cocultivated with Vero cells and used for an indirect fluorescent-antibody test. Clin Diagn Lab Immunol. 1995 Nov;2(6):693–695. [PMC free article] [PubMed]

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