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Clinical data of Bartonella infection in northern Greece

Abstract number: P1629

Pape M., Mandraveli K., Alexiou-Daniel S.

Objective: Cat scratch disease, caused by Bartonella henselae, typically presents with a localised lymphadenopathy. However, there are atypical cases with a wide spectrum of clinical manifestations. The aim of this study was to investigate the epidemiologic and clinical aspects of Bartonella infection in northern Greece.

Methods: Betweeen 2000–2006 we examined 1107 patients (522 adults/585 children) suspected of having CSD. The referring doctors were requested to provide the following information: contact with an animal, clinical signs and symptoms, physical findings and the histopathological results in the cases where a lymph node biopsy was performed. All sera were examined using the Bartonella IgG/IgM indirect immunofluorescent antibody (IFA) test (Focus kit). A serological diagnosis was made on the basis of either evaluated titers of IgM antibodies >/1:20 or IgG antibodies >/1:256, or the presence of a fourfold rise in the serum IgG titer between acute and convalescent phase. All sera were also tested to Coxiella burnetti, Rickettsia typhi/conorii, Chlamydia species, Cytomegalovirus, Epstein Barr virus, Respiratory syncitial virus, Mycoplasma pneumoniae and Legionella pneumophila to exclude cross reactions.

Results: In 101 patients the diagnosis of Bartonella infection was confirmed. 67 patients (29 adults/38 children) appeared typical clinical manifestations of CSD. In 15 out of 29 adults and in 18 out of 38 children contact with cats was reported. In two cases a contact with dogs was also reported. In five patients the histological examination of lymph nodes pointed out histopathological findings compatible with CSD. The most common sites of swollen lymph nodes were the neck (36 cases), followed by the axilla (25 cases), the inguinal region (3 cases) and the submandibular region (3 cases).

In 12 patients with fever of unknown origin (4 adults/8 children), 4 patients (3 adults/1 child) with fever and rash, 4 adults with pneumonia, 3 patients with neurological symptoms, and 5 patients with ocular manifestations the diagnosis of bartonella infection was also established. In six patients with culture negative endocarditis the association of their illness with Bartonella quintana infection was strongly suspected, based only on serological criteria

Conclusion:Bartonella infection was a rarely notifiable in Northern Greece. Our data indicate, however, that it should be considered a public health problem with several clinical manifestations.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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