APH 1999, 57, 287-300:

Contribution of the search for anti-Bartonella henselae antibodies in the diagnosis of the cat scratch disease in Belgium.

G. Bigaignon, C. Gusbin, A. Van Lint, M. Delmée, L. Boon-Falleur, T. M'Bilo, A. Aeby, P. Lepage, C. Potvliege, ML. Delforge, C. Rossi, and B.Sztern

Keywords: cat scratch disease, Bartonella henselae, sero-epidemiology

Cat Scratch Disease (CSD) is an infectious syndrome characterised by an inoculation papule on the skin scratched by a cat, followed by local lymphadenopathy. As presented here in 7 case reports, this infection can be complicated by septicaemia, endocarditis, encephalitis and bacillary angiomatosis.

The main causal agent (another is Afipia felis), a bacterium named Rochalimaea, then Bartonella henselae, can be cultivated; special slides have been adapted for serodiagnosis by indirect immunofluorescence assay (MRL Diagnostics, Cypress, California).

Over a 4 years period, between 23/12/1993 and 31/12/1997, the laboratory of Infectious serology of the University Hospital St-Luc received 2221 serum samples from patients with clinical signs suggestive of CSD, mainly in pediatrics and predominantly in male patients (sex ratio M/F: 1086).

The presence of antibodies IgG and/or IgM anti-Bartonella henselae was mainly observed among boys (in the first 4 decades: 14%, 18%, 16% and 20% of these patients and 12%, 12%, 10% and 13% among the girls).

These percentages of positivity were higher in the Western and Northern parts of Belgium (22% and 16% in male and female patients respectively), lower in the province of Luxembourg (12% and 10%) and intermediate in Brabant (15% and 10%),

These 276 positive results in 4 years, or 69 case reports per year, give an annual rate of infection with Bartonella henselae in Belgium of 0. 69 per 100 000 residents, very near the rate of 0.77 in the population of the United States.