ETIOLOGY OF CAT-SCRATCH DISEASE - COMPARISON OF POLYMERASE CHAIN-REACTION DETECTION OF BARTONELLA (FORMERLY ROCHALIMAEA) AND AFIPIA-FELIS DNA WITH SEROLOGY AND SKIN-TESTS

To determine the role of Bartonella (formerly Rochalimaea) species and Afipia felis in cat scratch disease (CSD), two polymerase chain react ion (PCR) hybridization assays were developed to detect DNA from these organisms. These assays were applied on 89 pus aspirates from skin te st-positive CSD patients (group 1) and on 137 pus and lymph node speci mens from CSD suspects (group 2). Bartonella DNA was detected in 96% o f the samples from group 1 patients and in 60% of group 2 samples; how ever, A. felis DNA could not be detected in any clinical samples. Thes e results suggest that CSD is caused by bartonellae and that A. felis does not play a significant role in this zoonosis. A strong correlatio n between Bartonella PCR positivity and Bartonella henselae antibody t iter was found. Comparison of CSD skin test results with those obtaine d by Bartonella PCR suggests a low sensitivity of the skin test.