Widening of the clinical spectrum of Bartonella henselae infection as recognized through serodiagnostics

Citation
F. Massei et al., Widening of the clinical spectrum of Bartonella henselae infection as recognized through serodiagnostics, EUR J PED, 159(6), 2000, pp. 416-419
Citations number
23
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pediatrics,"Medical Research General Topics
Journal title
EUROPEAN JOURNAL OF PEDIATRICS
ISSN journal
0340-6199 → ACNP
Volume
159
Issue
6
Year of publication
2000
Pages
416 - 419
Database
ISI
SICI code
0340-6199(200006)159:6<416:WOTCSO>2.0.ZU;2-F
Abstract
The recently improved diagnostics have widened, in children, the spectrum o f clinical manifestations recognisable as Bartonella henselae infection. We report here the clinical features of 20 (14 males) consecutive children wi th serologically proved B, henselae infection observed within 12 months in the Paediatric Department of the University of Pisa. The patients had a mea n age of 7 years 4 months (range 1.1-14.1 years). All children but one had a history of contact with kittens. Clinical manifestations included regiona l lymphadenopathy in 14 patients, representing in five the only clinical ma nifestation at onset. infectious mononucleosis-like syndrome in six, erythe ma nodosum in three, and Parinaud oculoglandular syndrome in one. In five p atients a severe disorder was first suspected: fever of unknown origin in t wo with multiple hepatosplenic granulomatosis in one: osteolitye lesion sug gesting bone neoplasm. marked inguinal lymph-node enlargement, suggesting B urkitt lymphoma, and an acute encephalopathy in one each. Bartonella hensel ae IgG antibody was positive in all patients with a titre ranging from 1:12 8 to 1:8590, IgM antibody was present in all except one child with an IgG t itre of 1:2048, All patients recovered, some spontaneously. Conclusion Bartonella henselae infection is frequent in Tuscany and probabl y underdiagnosed due to the high frequency of atypical onset of the clinica l manifestations. An accurate clinical history and a reasonably wide use of the serological test may allow a rapid and accurate diagnosis, reassuring the family of the patient and avoiding invasive and expensive diagnostic pr ocedures.