Evaluation of Immunohistochemistry in Identifying Bartonella henselae in Cat-Scratch Disease

Cat-scratch disease (CSD) is largely due to infection with Bartonella henselae. Microbiologic detection is difficult, and molecular testing is not readily available. A monoclonal antibody (mAB) to B henselae has become commercially available. We evaluated the usefulness of immunohistochemical analys...

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Bibliographic Details
Published in:American journal of clinical pathology 2009-02, Vol.131 (2), p.250-256
Main Authors: CAPONETTI, Gabriel C, PANTANOWITZ, Liron, MARCONI, Sharon, HAVENS, Jennifer M, LAMPS, Laura W, OTIS, Christopher N
Format: Article
Language:English
Subjects:
Adolescent
Adult
Antigens, Bacterial - analysis
Bacterial diseases
Bartonella henselae
Bartonella henselae - genetics
Bartonella henselae - immunology
Bartonella henselae - isolation & purification
Bartonella quintana
Bartonellosis
Biological and medical sciences
Cat-Scratch Disease - blood
Cat-Scratch Disease - diagnosis
Cat-Scratch Disease - microbiology
Child
Child, Preschool
DNA, Bacterial - analysis
Female
Human bacterial diseases
Humans
Immunohistochemistry - methods
Infant
Infectious diseases
Investigative techniques, diagnostic techniques (general aspects)
Lymphadenitis - diagnosis
Male
Medical sciences
Middle Aged
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Polymerase Chain Reaction
Predictive Value of Tests
Serologic Tests
Silver Staining - methods
Tropical bacterial diseases
Young Adult
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Description
Summary:Cat-scratch disease (CSD) is largely due to infection with Bartonella henselae. Microbiologic detection is difficult, and molecular testing is not readily available. A monoclonal antibody (mAB) to B henselae has become commercially available. We evaluated the usefulness of immunohistochemical analysis (IHC) for diagnosing CSD on surgical specimens and compared these results with polymerase chain reaction (PCR) detection and serologic testing for B henselae. We studied 24 formalin-fixed, paraffin-embedded (FFPE) cases of lymphadenitis with histologic and/or clinical suspicion of CSD. Control cases included 14 cases of lymphadenopathy other than CSD. FFPE tissue sections were evaluated with an mAB to B henselae, Steiner silver stain (SSS), and PCR that targeted B henselae and Bartonella quintana. Positive cases were as follows: SSS, 11 (46%); PCR, 9 (38%); and IHC, 6 (25%). Only 2 cases (8%) were positive for all 3 studies. All control cases were negative for IHC and PCR. The diagnostic sensitivity of these 3 tests is low for CSD. SSS seems to be the most sensitive test but is the least specific. PCR is more sensitive than IHC and may, therefore, serve as a helpful second-line test on all IHC- cases.
ISSN:0002-9173
1943-7722
DOI:10.1309/AJCPMNULMO9GPLYU