Bagcilar Medical Bulletin (Sep 2024)
Evaluation of Bartonella henselae IFA Seropositivity in Adult Patients Presenting with Various Symptoms at a Tertiary Education and Research Hospital
Abstract
Objective: Bartonella henselae, indirect , is the etiologic agent of cat scratch disease (CSD). Due to the difficulty of isolation and culture of Bartonella henselae, indirect fluorescent antibody (IFA) test is commonly used in diagnosis. In this study, we aimed to investigate the role of serology in the diagnosis of classical and atypical CSD by examining different serological titer values of patients with suspected CSD. Method: Patients were divided into 2 main groups as negative and positive according to the IFA test result. Patients with positive IFA titer were divided into 2 groups as suspected positive IFA (1:64-1:128) and positive IFA (≥1:256) and subgroup analysis was performed. Results: A total of 197 patients were included in the study and IFA tests were obtained from the laboratory database. The number of IFA immunoglobulin G seropositive patients was 57 (28.9%). The mean age of the patients was 37 (18-87) years, with 104 (52.8%) being female. While 49.7% of all patients had a history of cat contact, 61.4% of the patients in IFA test positive group had a history of cat contact (p=0.037). The most common symptom was lymphadenopathy (77.7%). Axillary lymphadenopathy was more common in the IFA positive group with a rate of 70.2% (p<0.001). The mean duration of LAP was 1 month in the IFA positive group and 2 months in the IFA negative group with a statistically significant difference (p<0.001). Unilateral LAP was significantly more common in the possible positive IFA group with a rate of 79.1% (p=0.043). Conclusion: CSD should be considered in the differential diagnosis of patients with cat contact who present with unilateral lymphadenopathy, especially in the axillary region, as Bartonella henselae infection is not uncommon in the population receiving service from our hospital. Although an IFA titer of ≥1/256 supports the diagnosis, it should be kept in mind that a negative IFA result does not exclude the CSD diagnosis.
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