Seronegative cat-scratch disease diagnosed by PCR detection of Bartonella henselae DNA in lymph node samples

Chondrogiannis, Konstantinos; Vezakis, Αntonios; Derpapas, Michael; Melemeni, Aikaterini; Fragulidis, Georgios P.

doi:10.1016/s1413-8670(12)70284-2

Cited by 17 publications

(16 citation statements)

References 22 publications

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“…Bartonella serology was supportive of B. henselae infection in the mother, but not in the son, further supporting reports of seronegative Bartonella sp. bacteremia in human patients [10,11,78,79]. Also, despite improvements in PCR sensitivity, immunohistochemical methods are useful to facilitate the visualization of Bartonella species in patient tissue specimens.…”

Section: Resultsmentioning

confidence: 99%

Bartonella henselae bacteremia in a mother and son potentially associated with tick exposure

et al. 2013

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BackgroundBartonella henselae is a zoonotic, alpha Proteobacterium, historically associated with cat scratch disease (CSD), but more recently associated with persistent bacteremia, fever of unknown origin, arthritic and neurological disorders, and bacillary angiomatosis, and peliosis hepatis in immunocompromised patients. A family from the Netherlands contacted our laboratory requesting to be included in a research study (NCSU-IRB#1960), designed to characterize Bartonella spp. bacteremia in people with extensive arthropod or animal exposure. All four family members had been exposed to tick bites in Zeeland, southwestern Netherlands. The mother and son were exhibiting symptoms including fatigue, headaches, memory loss, disorientation, peripheral neuropathic pain, striae (son only), and loss of coordination, whereas the father and daughter were healthy.MethodsEach family member was tested for serological evidence of Bartonella exposure using B. vinsonii subsp. berkhoffii genotypes I-III, B. henselae and B. koehlerae indirect fluorescent antibody assays and for bacteremia using the BAPGM enrichment blood culture platform.ResultsThe mother was seroreactive to multiple Bartonella spp. antigens and bacteremia was confirmed by PCR amplification of B. henselae DNA from blood, and from a BAPGM blood agar plate subculture isolate. The son was not seroreactive to any Bartonella sp. antigen, but B. henselae DNA was amplified from several blood and serum samples, from BAPGM enrichment blood culture, and from a cutaneous striae biopsy. The father and daughter were seronegative to all Bartonella spp. antigens, and negative for Bartonella DNA amplification.ConclusionsHistorically, persistent B. henselae bacteremia was not thought to occur in immunocompetent humans. To our knowledge, this study provides preliminary evidence supporting the possibility of persistent B. henselae bacteremia in immunocompetent persons from Europe. Cat or flea contact was considered an unlikely source of transmission and the mother, a physician, reported that clinical symptoms developed following tick exposure. To our knowledge, this is the first time that a B. henselae organism has been visualized in and amplified from a striae lesion. As the tick bites occurred three years prior to documentation of B. henselae bacteremia, the mode of transmission could not be determined.

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Section: Resultsmentioning

confidence: 99%

Bartonella henselae bacteremia in a mother and son potentially associated with tick exposure

et al. 2013

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“…In our case, histopathologically, the lesion showed suppurative granulomatous inflammation, and the WS stain detected clumps of bacilli, highly suggestive of CSD but not definitive [21,22]. Chondrogiannis et al described a sero-negative CSD case confirmed by PCR and mentioned limitations of histopathology [21].…”

Section: Letter To the Editormentioning

confidence: 73%

“…Chondrogiannis et al described a sero-negative CSD case confirmed by PCR and mentioned limitations of histopathology [21]. However, they also mentioned histopathologic examination of lymph nodes is crucial for exclusion [21,23]. …”

Section: Letter To the Editormentioning

confidence: 99%

A case report of seronegative cat scratch disease, emphasizing the histopathologic point of view

et al. 2014

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Cat scratch disease, necrotizing granulomatous lymphadenitis caused by Bartonella henselae, usually benign and self-limited. However, various clinical manifestations and no pathognomonic histopathologic features can lead to misinterpretations and diagnostic disputes. We report a case of cat scratch disease in a 39-yr-old male patient with fever and left axillary lymphadenitis. He had a history of cat bite on the left hand dorsum. On excision, the lymph node showed follicular hyperplasia, stellate microabscesses with a rim of granulomatous inflammation. Warthin-Starry silver staining showed many clumps of silver-stained bacilli within the necrotic foci. Serological tests were negative. Diagnosis was established by PCR analysis.Virtual slidesThe virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1877499238123059

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“…The diagnosis of CLD is even more complex when tick-borne coinfections occur in association with Lyme disease [ 105 ], which is the rule rather than the exception [ 106 ]. Routine laboratory tests exhibit varying reported sensitivity and are usually unhelpful in diagnosis, as serology fails in terms of specificity and/or sensitivity [ 107 ]. Clinically relevant coinfections include Bartonella species [ 105 ], Babesia [ 108 ], Anaplasma [ 109 ], Rickettsia [ 110 ], Yersinia enterocolitica , Chlamydophila pneumoniae , Chlamydia trachomatis , Mycoplasma pneumoniae [ 105 ], and tick-borne encephalitis virus, amongst others [ 108 , 111 ].…”

Section: Resultsmentioning

confidence: 99%

Relevance of Chronic Lyme Disease to Family Medicine as a Complex Multidimensional Chronic Disease Construct: A Systematic Review

Borgermans

Goderis

Vandevoorde

et al. 2014

International Journal of Family Medicine

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Lyme disease has become a global public health problem and a prototype of an emerging infection. Both treatment-refractory infection and symptoms that are related to Borrelia burgdorferi infection remain subject to controversy. Because of the absence of solid evidence on prevalence, causes, diagnostic criteria, tools and treatment options, the role of autoimmunity to residual or persisting antigens, and the role of a toxin or other bacterial-associated products that are responsible for the symptoms and signs, chronic Lyme disease (CLD) remains a relatively poorly understood chronic disease construct. The role and performance of family medicine in the detection, integrative treatment, and follow-up of CLD are not well studied either. The purpose of this paper is to describe insights into the complexity of CLD as a multidimensional chronic disease construct and its relevance to family medicine by means of a systematic literature review.

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Seronegative cat-scratch disease diagnosed by PCR detection of Bartonella henselae DNA in lymph node samples

Cited by 17 publications

References 22 publications

Bartonella henselae bacteremia in a mother and son potentially associated with tick exposure

Bartonella henselae bacteremia in a mother and son potentially associated with tick exposure

A case report of seronegative cat scratch disease, emphasizing the histopathologic point of view

Relevance of Chronic Lyme Disease to Family Medicine as a Complex Multidimensional Chronic Disease Construct: A Systematic Review

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