Abstract
Cat scratch disease (CSD), the typical clinical manifestation of Bartonella infections usually follows a typical benign self-limited course. Nevertheless, a variety of unusual clinical manifestations and confusing imaging features can lead to misinterpretations and render the disease a diagnostic dispute. Routine laboratory tests exhibit varying reported sensitivity and are usually unhelpful in diagnosis, as serology fails in terms of specificity and/or sensitivity. Herein we report a case of seronegative Bartonella infection presenting as symptomatic suppurative lymphadenitis with abscess formation, which was surgically drained. Diagnosis was established by PCR analysis from lymph nodes samples obtained during the procedure. PCR detection of specific DNA fragments from lymph node biopsy provides a sensitive detection of disease. The technique should be considered for patients with suspected CSD and negative serology, since serological assays exhibit low sensitivity. In ambiguous cases, surgical exploration may provide tissue for diagnosis; it is well tolerated and affords improved recovery.
References
Sep 30, 1983·Science·D J WearF M King
Jan 1, 1996·Microbiology and Immunology·H YoshidaK Tanikawa
Oct 6, 2000·American Journal of Ophthalmology·E T Cunningham, J E Koehler
Jul 31, 2001·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·A SanderM Ruess
Sep 3, 2002·Clinical and Diagnostic Laboratory Immunology·M MaurinD Raoult
Dec 20, 2002·Clinics in Laboratory Medicine·Brian K Agan, Matthew J Dolan
Oct 15, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Einat Metzkor-CotterMichael Giladi
Aug 2, 2005·Diagnostic Microbiology and Infectious Disease·Alessandra CiervoLorenzo Ciceroni
Aug 6, 2005·Journal of Clinical Microbiology·Yves HansmannBenoît Jaulhac
Nov 1, 2006·Emerging Infectious Diseases·Jean-Marc RolainDidier Raoult
Apr 30, 2008·Pediatrics·Todd A FlorinLisa B Zaoutis
Aug 6, 2008·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·M HerremansM P G Koopmans
Jun 30, 2009·Clinical Imaging·Chih-Wei WangGuo-Shu Huang
Dec 17, 2009·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Takeharu KogaMasahiro Arakawa
Mar 13, 2010·Journal of Medical Microbiology·Marijn J VermeulenMarcel F Peeters
Sep 7, 2011·Infectious Disease Reports·Georgios MinadakisAnna Psaroulaki
Citations
Apr 17, 2013·Parasites & Vectors·Ricardo G MaggiEdward B Breitschwerdt
Oct 31, 2013·Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine·Hiroyuki IijimaHiroshi Takahashi
Dec 17, 2014·International Journal of Family Medicine·Liesbeth BorgermansDirk Devroey
Mar 20, 2014·Diagnostic Pathology·Ok Ran ShinKyung Jin Seo
Jun 27, 2015·Pediatrics International : Official Journal of the Japan Pediatric Society·Sasagu KimuraShouichi Ohga
Apr 30, 2016·Case Reports in Radiology·Taylor RisingPauravi Vasavada
May 21, 2015·The New England Journal of Medicine·Elaine WyllieVirginia M Pierce
Feb 6, 2013·PLoS Neglected Tropical Diseases·Kevin KlinePeter J Hotez
Oct 5, 2013·Annales de dermatologie et de vénéréologie·M NajiG Guillet
Oct 12, 2018·Journal of Veterinary Internal Medicine·Pradeep NeupaneEdward B Breitschwerdt
Feb 9, 2019·PloS One·Valeria AllizondTiziana Musso
Nov 10, 2015·The American Journal of Surgical Pathology·Christine E JabcugaRebecca L King