Serological evidence of Bartonella henselae infection in patients awaiting heart transplantation.

Bartonella henselae, the etiologic agent of cat-scratch disease, causes a self-limited syndrome of fever and regional lymphadenopathy in immunocompetent hosts. In immunocompromised hosts, however, B. henselae can cause severe disseminated disease and pathologic vasoproliferation known as bacillary angiomatosis or bacillary peliosis. The role of the host immune response to B. henselae is critical in preventing progression tosystemic disease. The spectrum of disease, diagnosis and management of B. henselae infection in solid organ transplant recipients has not been well characterized. Only rare cases of bartonellosis in transplant recipients have been reported. The purpose of this study has been to determine the seroprevalence of B. henselae in patients awaiting heart transplantation, in our Regional Reference Transplantation Centre. The diagnosis of B. henselae is usually based on serological methods immunoglobulin M (IgM), IgG] because they are practical, simple and rapid. Serum samples from 21 (16 males and 5 females) patients awaiting heart transplantation, with a median age of 53±15 SD (range 8???68 years), were examined by indirect immunofluorescence assay. In our study we have found a B. henselae antibody positivity rate of 19.04% (4/21) and in particular, 1 of 21 (4.76%) patients presented IgM while 3 of 21 (14.28%) presented IgG. Our preliminary serological data seems to indicate that B. henselae is present in our area and more interestingly it can be also present in patients awaiting heart transplantation. Thus, on the basis of our data, we would recommend the importance of including B. henselae diagnosis also in pre-transplant patients.