Abstract
Bartonella Henselae is the causative agent of human cat-scratch disease (CSD). CSD can be diagnosed by histopathological examination, and by the enzyme immunoadsorbant assay (EIA) and polymerase chain reaction (PCR) methods, which detect B. Henselae DNA. Histopathological findings of CSD include granulomatous lymphadenitis with or without abscess formation. We examined 36 specimens of granulomatous lymphadenitis, including 15 abscess-forming granulomatous lymphadenitis, 9 non-abscess-forming granulomatous lymphadenitis, 10 tuberculosis and 2 sarcoidosis by PCR with primers specific for B. Henselae and Bartonella quintana. As controls, we examined 79 cases of non-granulomatous lymphadenitis, including 7 with dermatopathic lymphadenopathy, 18 Kikuchi's lymphadenitis (histiocytic necrotizing lymphadenitis), 18 follicular hyperplasia, 18 paracortical hyperplasia and 18 non-specific lymphadenitis. The PCR method identified B. henselae in 10 of 15 (67%) patients with abscess-forming granulomatous lymphadenitis and 2 of 9 (22%) with non-abscess-forming granulomatous lymphadenitis, but none in tuberculosis, sarcoidosis and non-granulomatous lymphadenitis. B. henselae was persistently detected in all but one patient from the appearance of symptoms to 4 months from onset in patients with abscess-forming and non-abscess-forming granulomatous lymphadenitis. Our results suggest that the PCR method is useful for establishing the diagnosis of CSD by detecting B. henselae.
