Cat-scratch disease in Hawaii: Etiology and seroepidemiology

Cat-scratch disease in Hawaii: Etiology and seroepidemiology

Objective: To study the etiology and seroepidemiology of cat-scratch disease (CSD) in Hawaii. Methods: Blood and fine-needle aspirate (FNA) from the lymph nodes of 39 consecutive patients with clinical CSD were cultured for Bartonella henselae, and blood samples from index cats, stray cats, and dogs...

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Bibliographic Details
Published in:The Journal of pediatrics Vol. 127; no. 1; pp. 23 - 26
Main Authors: Demers, Denise M., Bass, James W., Vincent, Judy M., Person, Donald A., Noyes, Diane K., Staege, Cathy M., Samlaska, Curt P., Lockwood, Neal H., Regnery, Russell L., Anderson, Burt E.
Format: Journal Article
Language:English
Published: New York, NY Mosby, Inc 01-07-1995
Elsevier
Subjects:
Adolescent
Adult
Animals
Bacterial diseases
Bartonella - immunology
Bartonella - isolation & purification
Bartonellosis
Biological and medical sciences
Cat-Scratch Disease - blood
Cat-Scratch Disease - epidemiology
Cat-Scratch Disease - etiology
Cats
Child
Child, Preschool
Dogs
Female
Fluorescent Antibody Technique
Hawaii - epidemiology
Human bacterial diseases
Humans
Immunoglobulin G - immunology
Incidence
Infant
Infectious diseases
Male
Medical sciences
Prospective Studies
Seroepidemiologic Studies
Tropical bacterial diseases
Tropical medicine
Hawaii
Polynesia
Oceania
FNA
WS
CSD
IFA
Human
Bartonella
Cat scratch disease
Aspiration punction
Epidemiology
Infection
Afipia felis
Fine needle
Adenopathy
Bacteriosis
Bacteria
Bartonellaceae
Diagnosis
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Summary:Objective: To study the etiology and seroepidemiology of cat-scratch disease (CSD) in Hawaii. Methods: Blood and fine-needle aspirate (FNA) from the lymph nodes of 39 consecutive patients with clinical CSD were cultured for Bartonella henselae, and blood samples from index cats, stray cats, and dogs were cultured and their sera were tested by indirect fluorescence antibody test for antibodies to B. henselae and Afipia felis. Sera from age- and sex-matched human subjects without cat exposure served as controls. Results: Warthin-Starry staining showed positive results in only 4 of 32 FNAs, and B. henselae was isolated from only one FNA specimen. All of 38 patients who had two or more sera tested had elevated titers of antibody to B. henselae. Only 1 of 48 human control sera had antibody to B. henselae. Of 31 kittens, 21 had positive blood culture results and elevated antibody titers to B. henselae. Of three adult cats, all had negative blood culture results, but they had serologic evidence of past infection. Of 23 adult stray cats, 18 had elevated titers of antibody to B. henselae, but in only one was the blood culture result positive. Results of IFA tests were marginally positive for A. felis in 1 of 29 patients with CSD and in one adult stray cat and one dog. Conclusions: This study shows that the B. henselae IFA test is both highly sensitive and specific for the detection of infection caused by B. henselae and for the laboratory diagnosis of CSD, and that FNA is seldom helpful in confirming the diagnosis. We further demonstrated that CSD in Hawaii is due to B. henselae and that infection is directly linked to the scratch or bite of a kitten. Older cats seldom have bacteremia but often have serologic evidence of past infection. Our study fails to implicate dogs in the epidemiology of CSD in Hawaii, and A. felis was not etiologically implicated in CSD in the human subjects and animals we studied. (J P EDIATR 1995;127:23-6)
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0022-3476
1097-6833
DOI:10.1016/S0022-3476(95)70251-2