Serological cross-reactions between Bartonella quintana, Bartonella henselae, and Coxiella burnetii

J Clin Microbiol. 1996 Sep;34(9):2270-4. doi: 10.1128/jcm.34.9.2270-2274.1996.

Abstract

The clinical manifestations of Q fever and bartonelloses can be confused, especially in cases of infectious endocarditis. Differential diagnosis of the diseases is important because the treatments required for Q fever and bartonelloses are different. Laboratory confirmation of a suspected case of either Q fever or bartonelloses is most commonly made by antibody estimation with an indirect immunofluorescence assay. With an indirect immunofluorescence assay, 258 serum samples from patients with Q fever were tested against Bartonella henselae and Bartonella quintana antigens, and 77 serum samples from patients with infection by Bartonella sp. were tested against Coxiella burnetii antigen. Cross-reactivity was observed: more than 50% of the chronic Q fever patients tested had antibodies which reacted against B. henselae antigen to a significant level. This cross-reaction was confirmed by a cross-adsorption study and protein immunoblotting. However, because the levels of specific antibody titers in cases of Bartonella endocarditis are typically extremely high, low-level cross-reaction between C. burnetii antibodies and B. henselae antigen in cases of Q fever endocarditis should not lead to misdiagnosis, provided serology testing for both agents is performed.

MeSH terms

  • Angiomatosis, Bacillary / diagnosis*
  • Angiomatosis, Bacillary / immunology
  • Antibodies, Bacterial / blood
  • Antibodies, Bacterial / immunology*
  • Bartonella henselae / immunology
  • Bartonella henselae / isolation & purification*
  • Bartonella quintana / immunology
  • Bartonella quintana / isolation & purification*
  • Coxiella burnetii / immunology
  • Coxiella burnetii / isolation & purification*
  • Cross Reactions
  • Diagnosis, Differential
  • Humans
  • Q Fever / diagnosis*
  • Q Fever / immunology
  • Trench Fever / diagnosis*
  • Trench Fever / immunology

Substances

  • Antibodies, Bacterial