Cat scratch disease Bartonella henselae

Cat scratch disease blood test Bartonella henselae IgG and IgM (serum).

Cat scratch disease is an infection with Bartonella henselae, caused by a bite or scratch from a cat infected with Bartonella henselae or (perhaps) by an infected tick.

According to a study by the RIVM, 56% of cats in the Netherlands are infected with Bartonella henselae. According to the RIVM, B. henselae does not occur in ticks in the Netherlands and you can therefore not contract Bartonella from a tick bite. However, many studies from surrounding countries - and earlier studies from the Netherlands - come to different conclusions and chronic Lyme disease patients remarkably often test positive for Bartonella.

Cat scratch disease is generally a harmless disease, sometimes accompanied by fever, which usually goes away by itself. It starts three to five days after the patient has been scratched or bitten by a cat, with one or more small red pimples on the skin that are not filled with pus (2-3 mm) on the skin, where the scratch took place. These turn into vesicles with fluid in them. After a few days, crusts appear, after which the wounds quickly disappear. It is not uncommon for this to go unnoticed.

After about two weeks, when only a small scar is visible from the first injury, a (pressure) painful, large lymph node swelling may occur, sometimes more than one. The swelling occurs in a lymph node usually at the head, neck, armpit or elbow crease, less often in the groin or below. The severity of the inflammation of the lymph node varies, but may be accompanied by marked enlargement of the gland, warmth and redness of the underlying skin, and pus formation.

In about one-third of patients, the disease is accompanied by fever (usually <39°C), headache, and a flu-like sensation in the first days to weeks. In about 2% of patients, symptoms of encephalitis subsequently develop, manifesting as lowered consciousness or even coma. The encephalitis may persist for weeks or months (on average six weeks), but eventually disappears spontaneously and without residual symptoms.

In a small proportion of patients (1-3%) Cat Scratch Disease manifests as an infection that spreads throughout the body, with inflammatory foci in bone, liver, spleen or lung. This initially causes a flu-like feeling with mild fever, muscle aches, minor head or neck pain, fatigue, night sweats and swollen lymph nodes. The infection is more serious in people where the immune system does not work properly (especially AIDS and people with kidney transplant).
Because Bartonella can cause neurological disorders, it can cause psychiatric disorders.

Symptoms Bartonella infection

• Skin abnormalities, such as striae-like spots, bullous lesions, and pus pockets
• Depression
• Fatigue
• Balance disorder
• Joint pain

Immunity

There are no reports of anyone having cat scratch disease in humans for a second time.


Cause of infection

Fleas play an important role in the transmission of B. henselae. Transmission from cats to humans most likely occurs through contamination of scratch and bite wounds with flea droppings.
Direct human-to-human transmission has not been described.

Ticks as vectors are suspected of transmitting B. henselae, but in the Netherlands the risk for humans of contracting B. henselae via the tick Ixodus ricinus is negligible (Tijsse-Klasen 2011). Occasionally B. henselae is also found in dogs (Guptill-2 2010).
The disease usually occurs in children and young adults, because they play with cats the most. The best way to prevent the disease is to control fleas. Young cats are especially at risk, as they carry the bacteria most often.

The incubation period is about 2-4 weeks.
Method: IFT (immuno-fluorescence test)

• bartonella henselae IgG* if the titer is higher than 1:320, antibodies against this disease have been produced.
• bartonella henselae IgM* if the titer is higher than 1:100 then there is an acute infection.

A more expensive but more reliable PCR (DNA) test is also available.

The reporting time of this test is a bit longer than other tests, after receiving it at the lab it will take about 7 working days before you receive the result by mail