First isolation and genotyping of Bartonella henselae from a cat living with a patient with cat scratch disease in Southeast Europe.

Stepanić M, et al. BMC Infect Dis. 2019.


BACKGROUND: The bacterial genus Bartonella is distributed worldwide and poses a public health risk. Cat-scratch disease caused by B. henselae in Croatia was first described in 1957. It is present throughout the country: a survey of serum samples from 268 Croatian patients with lymphadenopathy showed that 37.7% had IgG antibodies. Despite this prevalence, we are unaware of reports of Bartonella culturing from infected humans or cats in Croatia or elsewhere in southeast Europe.

CASE PRESENTATION: Here we describe the diagnosis of a 12-year-old child with lymphadenopathy in Croatia with cat-scratch disease based on antibody detection and clinical signs, and the subsequent culturing and genotyping of B.henselae from the cat’s blood. The B. henselae isolate was grown on different blood agar plates and its identity was confirmed based on polymerase chain reaction (PCR) amplification of 16S ribosomal deoxyribonucleic acid (16S rDNA) and sequencing. Multi-locus sequence typing (MLST) identified the strain genotype as sequence type 5, commonly found zoonotic B. henselae strain in cats. The child recovered after azithromycin therapy, and B. henselae in the cat was eliminated within three months after doxycycline treatment.

CONCLUSIONS: This is, to our knowledge, the first report of B. henselae culturing and MLST-based genotyping from cat’s blood in southeast Europe. Our ability to detect B. henselae in blood through culturing but not PCR suggests that the prevalence of infected cats with low bacteremia is very high, suggesting the need to develop faster, more sensitive detection assays.



Bartonella is everywhere and finally getting the press it deserves. Nearly every Lyme/MSIDS patient I know has it yet the U.S. is in denial. 

Perfectly healthy people can become infected without any cat exposure:  All the patients denied a history of a cat or any animal contact, or of having CSD findings.  Healthy 1.5-year-old girl who was seen in hospital for the sparing use of her left arm when crawling. Tested positively for Bartonella henselae.  Case of a 53-year-old healthy man, presenting with confusion. Serology confirmed Bartonella henselae infection.  Healthy 10 year old girl had coexisting transverse myelitis and Guillain-Barré syndrome (GBS) related to infection with Bartonella henselae.  While cats are implicated, this 3 year old had no significant medical history, presented at emergency department for a 2-week history of worsening scalp lump with redness.  All immunocompetent hosts.

Lastly, this article points out the importance of utilizing blood culture vs PCR for Bartonella.  PCR tests require much less time, less skill to interpret the results, less waste, which all culminate to less cost; however, as you can see from the last item in the list, traditional culture method (TCM) beats out PCR in the area of rare and emerging pathogens.  List below derived from this:

Differences between TCM & PCR testing:

    • Skill Level Required: Knowing what to look for can be tough when it comes to traditional culture method TCM. While some tests are cut and dry — the organism either grew up or it didn’t — others require a bit of interpretation in order to be correctly read. Bacterial identification is an art form that can take years to perfect. This translates out into higher wages and more skill required for TCM.
    • Time to Result: Bacteria grow on their own schedule. More time spent waiting typically means more cost for TCM.
    • Accuracy: There’s always one oddball out in a crowd, and bacteria are no different. There’s always one cell that just won’t conform to the standardized norm for a species. Because many of the traits that TCM look for are considered non-essential traits by the organism in question, there’s always the possibility that a pathogenic organism could be missed even by the most seasoned technician.
    • Waste Generated: At first glance, the amount of waste each test generates per sample doesn’t seem like an important concern, but it is. Consider this: each pound of waste generated has to be disposed of properly. And because TCM often require both the primary and secondary enrichment to be plated in replicates of 5, all of those plates add up to quite the pile.
    • Cost: It’s not just the cost of reagents that needs to be considered. The longer time required for TCM keeps staff from doing other important tasks, and the differences in the amount of reagents needed. Sure, a single plate may cost only $0.25, but when you’re going through 24 at a time, that can add up quickly.
    • Diversity of Available Tests: This is where TCM beats out Real-Time PCR. There are still some very rare and emerging pathogens where Real-Time PCR tests don’t yet exist – at least not commercially available and approved versions. For these very rare pathogens, TCM is still the method of choice.

There has been a concerted suppression of microscopy for Lyme/MSIDS:

This article also reveals how Lida Mattman’s Gold Standard Culture Method has disappeared thanks to this concerted suppression on microscopy.

Could it be that folks sitting on the CDC/NIH/IDSA boards have patents on testing?  YEP! ConflictReport

It is high time authorities allow & promote direct testing for Lyme/MSIDS.