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Original Articles
Prevalence of antibodies to Bartonella henselae and Bartonella quintana in Korean Patients with Lymphadenopathy
Min Byoung Chae, M.D., Ji Young Lee, M.D., Yee Gyung Kwak, M.D., Sung Hak Park, M.D., Hee Jung Lim, M.D., Sang Woo Park, M.D., Moon-Hyun Chung, M.D., Mee Kyoung Kim, M.D.*, and Jae Seung Kang, M.D.*
Department of Internal Medicine and Department of Microbiology*, In-Ha University School of Medicine, Inchon, Korea
Vol.34 Num.5 (p305~310)
Background:Cat scratch disease (CSD) manifests as a self-limiting, regional lymphadenopathy, fever and constitutional symptoms following a cat scratch or close contact with cats. Bartonella henselae is a causative agent of CSD that is globally distributed. In Korea there are no case report of CSD and no reports on the seroprevalence of Bartonella henselae in patients with suspected CSD. In this study the prevalence of antibodies to Bartonella in patients with lymphadenopathies was evaluated.
Methods:We evaluated serological responses of 31 patients (8 male, 23 female) with regional lymphadenopathies. The age of the patients ranged from 6 to 76 years old (mean±S.D., 30.6±14.3 years). Final diagnoses on the lymphadenopathies were tuberculous lymphadenopathy, Kikuchi's disease, Kawasaki's disease, and viral infection, but considerable cases remained undiagnosed. All sera were examined using MRL Diagnostics Bartonella IgG indirect immunofluorescent antibody (IFA) test kits (MRL Diagnostics, Cypress, California, USA) according to the manufacturer's instructions.
Results:Of the 31 patients, 21 (67.7%) patients showed positive titers of immunoglobulin G (IgG) to B. henselae (1:64 or higher). Twelve (38.7%) had IgG titers of 1:128 and four (12.9%) had titers of 1:256. Among these patients, three patients had a history of close contact with a cat or cat scratch. Twenty patients (64.5%) showed positive reactions against B. quintana.
Conclusion:This study revealed possible patients with cat scratch disease, but, unlike other countries, Bartonella seropositivity was not closely associated with cat contact. The further studies should be performed in a large number of patients including a control group and be accompanied with culture or polymerase chain reaction of extirpated lymph node.
Keywords : Cat scratch disease, Bartonella henselae, Bartonella quintana, Lymphadenopathy, Seroprevalence