Cat-scratch disease (CSD) may lead ...

Cat-scratch disease (CSD) may lead to put offed lymphadenopathy, which sometimes is accompanied through fever and malaise that may raise bear upons about an occult malignancy. a patients with CSD have atypical features, as it was as eye involvement, encephalitis, endocarditis, hepatitis, or osteomyelitis. latter advances in serologic testing have improved the ability to reliably diagnose this repeatedly clinically vague infection. Metzkor-Cotter and colleagues describe the use of an enzyme immunoassay (EIA) technique for diagnosis of CSD

The greatest in number widely used diagnostic test for CSD at current is an immunofluorescent antibody assay, on the other hand it is technically difficult to perform and tending to interobserver variability regarding the interpretation of immunofluorescence. Because the EIA described in this research is numeric, there is no ne for subjective interpretation. The authors recorded 98 patients with clinical and serologic evidence of CSD in their investigation About 95 percent of the bring under rules had regional lymphadenopathy (most commonly axillary, inguinal, or cervical), and about single half reported fever and malaise. The in the greatest degree common atypical manifestation was watch involvement (oculoglandular syndrome or neuroretinitis), which was noted in about 10 percent of subjects

Anti-Bartonella henselae IgM titers were positive in 53 percent of patients, while 92 percent had positive anti-B. henselae IgG flushs The first serologic sample was obtained three weeks after the infection began, forward average, and patients were followed for a median duration of 35 weeks. the pair IgM and IgG titers declined through the whole extent of time. Within three months, 92 percent of patients with initially positive IgM plains became seronegative. IgG titers persisted for more than couple years in some patients. All patients with positive IgG titers measured at a flat of 1.0 optical density or more were within the first 12 month of CSD infection. Neither the initial antibody titers nor their decline above time correlated with disease severity or duration.

The authors determine that the presence of anti-B. henselae IgM through EIA indicates an acute storm of infection within the previous three month yet it is present in barely one half of CSD patients. The inactive decline in IgG levels impedes any use of acute and convalescent titers to identify the attack of infection, and the lack of correlation between antibody titers and CSD course inhibits its use as a monitor of disease activity.

Metzkor-Cotter E et al. Long-term serological analysis and clinical follow-up of patients with cat scratch disease. Clin Infect Dis November 1 2003;37:1149-54

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