RESUMO
This study was conducted on 60 patients and 30 apparently healthy controls The 60 patients were attending Ain Shams University Hospitals in the period from January 2002 to December 2002. They were suffering from fever of unknown origin [FUO] and/or lymphadenopathy. They were classified into: group I including 15 patients having lymphadenopathy, group II including 28 patients suffering from fever of unknown origin, and group III which included 17 patients suffering from fever and lymphadenopathy. The patients were selected after exclusion of other common causes of FUO and lymphadenopathy. All the studied patients were subjected to history, clinical examination which included general and abdominal examination, laboratory testing of serum and blood samples of patients and controls for the presence of Bartonella henselae by indirect immunofluorescent assay [IFA] and polymerase chain reaction [PCR]. Five patients were positive by IFA for Bartonella hensetae [B hensetae] two out of 15 patients with lymphadenopathy [13.3%], and one [3.6%] out of 28 having FUO in addition to two patients [11.8%] out of 17 patients having fever and lymphadenopathy. The control group was B. henselae negative by IFA technique. Meanwhile, 7 patients were positive for B. henselae by PCR using Bartonella univerasl primer, 5 of them were positive for B. henselae [they were also positive by IFA], the other two [7.1%] belonged to FUO group, and were positive by PCR for B. bacilliformis. None of the control group was positive for Bartonella by PCR.Our work showed that there was no statistical significant difference between the 3 studied groups of patients regarding PCR and IFA results [P>0.05]. Also, no statistical significant difference was found between patients and controls [P>0.05]. Moreover, there was no statistical significant association between Bartonella infection and hepatosplenomegaly [P>0.05]. The specificity and sensitivity of IFA test as compared to PCR was 100% and 71.4% respectively, the diagnostic accuracy was 97.8%. Moreover, there was a perfect agreement between IFA and PCR techniques as the value of kappa was 0.822. We concluded that B. henselae should be taken into consideration while following up patients with FUO and/or lymphadenopathy. Moreover, IFA is a very good screening test for the diagnosis of B. henselae with good sensitivity and specificity, however, it should be confirmed by PCR. PCR is a rapid, highly sensitive and specific test which is important and helpful to clinician to confirm the diagnosis of Bartonella