Serologic responses to Bartonella and Afipia antigens in patients with cat scratch disease.
OBJECTIVE
To assess the serologic response to Afipia and Bartonella, previously named Rochalimaea, in patients with cat scratch disease (CSD) and a healthy control group.


METHODS
Prospective, controlled trial.


METHODS
Referral clinic and hospitalized patients in a university medical center.


METHODS
Eighty patients with CSD and 57 healthy control subjects of similar age.


METHODS
The immune responses to Afipia felis and Bartonella henselae were evaluated by a newly developed enzyme-linked immunosorbent assay (ELISA) in patients with CSD and healthy control subjects. Responses to B henselae were also measured by indirect fluorescent antibody (IFA) tests. Antibody levels to Bartonella quintana were measured by ELISA and IFA in a limited number of patients and control subjects.


RESULTS
Of the 80 patients with clinical CSD, 56 had positive results of CSD skin tests. ELISA antibody levels to A felis did not differ between patients and control subjects, but immunoglobulin M (IgM) and IgG ELISA antibodies to B henselae and B quintana were significantly higher in patients than in control subjects. IFA responses to B henselae and B quintana were also significantly higher in patients than in control subjects.


CONCLUSIONS
Patients with CSD had significant serologic responses to B henselae and B quintana but not to A felis, suggesting that the causative agent of CSD is antigenically related to the Bartonella genus and not to Afipia. The Bartonella IgM ELISA and IFA assay were both sensitive and specific and may be used to establish the diagnosis of CSD.
D000293:Adolescent; D000328:Adult; D000942:Antigens, Bacterial / Q000276:immunology*; D001474:Bartonella Infections / Q000276:immunology*; D018416:Bartonella henselae / Q000276:immunology*; D002372:Cat-Scratch Disease / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods / Q000706:statistics & numerical data; D019084:Fluorescent Antibody Technique, Indirect / Q000379:methods / Q000706:statistics & numerical data; D006090:Gram-Negative Bacteria / Q000276:immunology*; D016905:Gram-Negative Bacterial Infections / Q000276:immunology*; D006801:Humans; D007223:Infant; D011446:Prospective Studies; D012882:Skin Tests / Q000379:methods / Q000706:statistics & numerical data; D018709:Statistics, Nonparametric
D000942:Antigens, Bacterial