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 manufac-turer'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.
Aged ; Animals ; Antibodies* ; Bartonella henselae* ; Bartonella quintana* ; Bartonella* ; California ; Cat-Scratch Disease ; Cats ; Cupressus ; Diagnosis ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Immunoglobulin G ; Korea ; Lymph Nodes ; Lymphatic Diseases* ; Male ; Polymerase Chain Reaction ; Prevalence* ; Seroepidemiologic Studies

Since microbial gene sequencing was utilized for etiologic diagnosis of culture-negative endocarditis, cases of Bartonella endocarditis have been reported in various countries. Herein we report the first case of Bartonella quintana endocarditis, which was confirmed for the first time in Korea by 16S rRNA gene sequencing from the excised valve. A 75-yr-old woman was hospitalized due to dyspnea. Echocardiography demonstrated large oscillating vegetation at the aortic valve. Blood culture was negative. She underwent valve replacement and sequencing of the 16S rRNA gene from excised valve identified Bartonella quintana. She was successfully treated with combined use of ceftriaxone and gentamicin.
Aged, 80 and over ; Anti-Bacterial Agents/therapeutic use ; Aortic Valve/pathology ; Bartonella quintana/genetics/*isolation & purification ; Ceftriaxone/therapeutic use ; Drug Therapy, Combination ; Dyspnea/etiology ; Echocardiography ; Endocarditis, Bacterial/*diagnosis/drug therapy/microbiology ; Female ; Gentamicins/therapeutic use ; Humans ; RNA, Ribosomal, 16S/genetics ; Republic of Korea ; Sequence Analysis, RNA