Test Summary

This antibody panel helps diagnose infections with Bartonella henselae and Bartonella quintana. This panel includes IgM and IgG antibodies with reflexes to titers for positive results.

B henselae causes cat scratch disease, a self-limiting bacterial infection transmitted via exposure to cats or cat fleas. B quintana causes trench fever, a febrile bacteremic illness transmitted via body lice. B henselae and B quintana are the 2 Bartonella species that most frequently cause blood culture-negative endocarditis. In immunocompromised individuals, infections with B henselae and B quintana may present as bacillary angiomatosis, a vasculoproliferative disease of the skin [1-4].

Because of the fastidious nature of B henselae and B quintana, recovery of these bacteria is rarely successful, especially from blood. Serology is commonly used for diagnosing Bartonella infections [1,3]. Confirmation of recent or current infection with either B henselae or B quintana may require testing of serial specimens to demonstrate a 4-fold increase of IgG titers or the presence of IgM. A B henselae or B quintana IgG titer of 1:800 has been proposed as a major criterion for diagnosing Bartonella endocarditis [4].

IgG cross-reactivity between B henselae and B quintana often occurs [1,3]. Qualitative real-time polymerase chain reaction is a highly specific and sensitive method to detect the presence of Bartonella species DNA in clinical specimens and can differentiate between B henselae and B quintana.

The results of this test should be interpreted in the context of pertinent clinical history and physical examination findings.

References
1. Dumler JS, et al. Bartonella. In: Carroll KC, et al, eds. Manual of Clinical Microbiology. 12th ed. ASM Press; 2019. https://www.clinmicronow.org/doi/book/10.1128/9781683670438.MCM.ch50
2. Centers for Disease Control and Prevention. Bartonella infection (cat scratch disease, trench fever, and Carrion's disease). Last reviewed December 18, 2019. Accessed January 28, 2022. https://www.cdc.gov/bartonella/clinicians/index.html
3. Miller JM, et al. Clin Infect Dis. 2018;67(6):813-816.
4. Okaro U, et al. Clin Microbiol Rev. 2017;30(3):709-746.

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