Serologic Study of Bartonella henselae in Patients with Acute Undifferentiated Febrile Illness in Korea

초록

Background:Bartonella infection is an emerging cause of acute febrile illness; however, its significance has not been thoroughly investigated. We studied the antibody specific to Bartonella henselae in patients with various febrile diseases in Korea. Materials and Methods: A total of 177 patients with acute febrile illness who were managed at the Inha University Hospital from February 2012 to January 2013 were evaluated with an in-house immunofluorescent antibody test to detect B. henselae immunoglobulin G (IgG) antibody. The clinical features of the patients included fever of undetermined origin (n=88 patients), lymphadenopathy (n=28), febrile rash (n=17), respiratory infection (n=12), aseptic meningitis (n=7), intra-abdominal infection (n=5), arthritis (n=4), and other conditions (n=16). We reviewed the medical records of these patients and collected demographic data, clinical features, and their histories of animal exposure. Results: Among the 177 patients with acute febrile illness, 23.7% (42/177) had elevated levels of IgG antibodies to B. henselae (1:160). Of these seropositive patients, 32.4% (12/37) had contact with animals and had developed arthralgia (29.5%), headache (25%), or lymphadenopathy (15.9%). Seven (16.7%) of the 42 patients had higher IgG titers (1:640). Among them, four patients presented fourfold increase/decrease of IgG in convalescent serum. According to the clinical diagnosis, the antibody positivity rates were as follows: 24/88 with undifferentiated fever, 8/28 with lymphadenopathy, 4/17 with febrile rash, 2/12 with respiratory infection, 2/7 with aseptic meningitis, and 2/16 with other illnesses. Conclusions: There was high prevalence of B. henselae in patients with undifferentiated fever in Korea, for which further research is needed.

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