Molecular Diagnosis of Cat Scratch Disease: a 25-Year Retrospective Comparative Analysis of Various Clinical Specimens and Different PCR Assays

• DOI: 10.1128/spectrum.02596-21
• Publication Date: 2022-03-09T16:01:41Z
• Authors: Sher Goaz; Michal Rasis; Inbal Binsky Ehre...; Lev Shapira; Ora Halutz; Merav Graidy-Varon; Cecilia Leibovitch; Noam Maisler; Daniel Glikman; Moshe Ephros; Michael Giladi
• Keywords: Cat-scratch disease; Lymph node biopsy; Etiology

Cat-scratch disease (CSD), caused primarily by Bartonella henselae, is a common etiology of infectious regional lymphadenopathy. Lymphadenopathy preceded primary inoculation lesion and may progress to suppuration. Laboratory diagnosis CSD hampered the limitations available confirmatory tests. PCR, in general, highly sensitive specific; however, clinical sensitivity varies greatly between studies. We aimed identify specimens PCR assays best suited for using national registry uniform case definition. Different assays, including conventional real-time were evaluated. was positive 335/390 (86%) patients 425/482 (88%) The highest achieved lymph node pus aspirates (96%; n = 278 tests) followed lesions (88%; 50), fine needle aspirations (85%; 46), biopsy (73%; 91) paraffin-embedded nodes (59%; 17), (P < 0.001). Sensitivity similar all types studied. negative predictive value aspirate specimen patient groups 82% 72%, respectively. Specificity 100% based on 125 non-CSD with PCR. In conclusion, type rather than assay has major impact molecular diagnosis. assume that inadequate due sampling errors or presence inhibitory factors. Primary should be sampled more frequently Physicians aware low specimens. IMPORTANCE Polymerase chain reaction (PCR) detection henselae an important tool cat scratch (CSD); current study shows type, aspiration, having significantly higher fresh formalin-fixed specimen, assay, whether performance diagnostic CSD. new data provide tools microbiologist when interpreting results assays. lesions, although easily accessible, are often neglected particularly if performed specimens, does not exclude