A doença da arranhadura do gato é descrita como uma linfadenite benigna que pode progredir para formas recorrentes ou severas, sendo isto ocassionalmente associado com morbidade. Entre janeiro de 1998 e março de 1999, 43 pacientes foram admitidos no Hospital Cayetano Heredia e no Instituto de Salud del Niño, em Lima -Peru. Doze pacientes tiveram o diagnóstico confirmado, sendo 8 mulheres, com uma média de idade de 10 anos. A maioria (53,3%) dos casos foram recrutados no verão. Todos os pacientes relataram ter contato com gatos. Febre, mal-estar, linfadenopatia e lesões cutâneas foram as características mais freqüentes. Doze pacientes tiveram títulos de imunofluorescência indireta (IFI) entre 1/50 e 1/800 para Bartonella henselae e Bartonella clarridgeiae. Duas biópsias de linfonodos foram descritas como típicas para doença da arranhadura do gato. Nenhuma hemocultura se mostrou positiva. Este é o primeiro estudo peruano prospectivo que foi capaz de identificar Bartonella henselae e Bartonella clarridgeiae em pacientes pediátricos.

Cat-Scratch Disease (CSD) is a benign lymphadenitis that may progress to severe or recurrent forms, and it is occasionally associated with morbidity. Between January of 1998 and March of 1999, forty-three suspected CSD patients were assessed in the Hospital Cayetano Heredia and the Instituto de Salud del Niño, in Lima, Peru. Twelve patients had a confirmed diagnosis, 8 of whom were women, and the mean age was 10 years old. The majority (53%) of the cases were encountered in the summer. All patients reported having had contact with cats. Fever, malaise, lymphadenopathy and skin lesions were the most frequent clinical features. Twelve patients had indirect immunofluorescence antibody test titers of between 1/50 and 1/800 for Bartonella henselae and Bartonella clarridgeiae. Two lymph node biopsies were histologically compatible with CSD. No positive blood cultures could be obtained. This is the first Peruvian prospective study able to identify B. henselae and B. clarridgeiae in pediatric patients.

Background: The PCR methodology amplifies a sequence of DNA with the Polimerase enzyme; the sensibility and specificity is very high. Objective: To develop a PCR methodology designed to work on extracts from whole blood samples rather than from isolated, cultured organisms. Methods: The whole blood of six patients with clinical and microbiologic diagnosis of acute bartonelosis by B. bacilliformis was used. The DNA was extracted with DNAzol® BD (lysis solution with guanidine detergent), and the extract subjected to PCR using primers 16S and 23S for the Intergenic Transcribed Spacer (ITS). The amplified products were subjected to electrophoresis on 1% agarose gels. Results: The concentration of the extracted product with DNAzol® BD was around 6 ng. The amplified single sized product of 1000 base pairs was identical to that from authentic cultures of B. bacilliformis and clearly different from that of other species. The dilutions detected by PCR were 1/5 and 1/10. Conclusion: The amplification of the DNA of B. bacilliformis extracted with DNAzol® BD from whole blood of patients with acute bartonelosis using the primers 16S and 23S is possible using this method for a fast etiologic diagnosis.

Introducción: La técnica de PCR amplifica una secuencia de ADN con la enzima polimerasa; es muy sensible y específica. Objetivo: Estandarizar una técnica de PCR para identificar Bartonella bacilliformis en sangre total de pacientes con bartonelosis aguda. Material y métodos: Se usó muestras de sangre total de seis pacientes con diagnóstico clínico y microbiológico de bartonelosis aguda. Se extrajo el ADN de sangre total usando el detergente guanidina DNAzol® BD. Se amplificó el ADN usando los cebadores de extensión "primers" 16S y 23S del espaciador de trascripción interna (ITS). Se hizo electroforesis de los productos de amplificación en gel de agarosa. Se compararon los pesos moleculares de las bandas observadas en la electroforesis con un marcador de 100 pares de bases. Resultados:Se determinó que la concentración de ADN extraído por DNAzol® BD corresponde alrededor de 6 ng de ADN. El producto amplificado de muestras de sangre total fue alrededor de 1000 pares de bases, idéntico al extraído de los hemocultivos de B. bacilliformis y claramente diferente del de otras especies. Las diluciones de las extracciones mejor detectadas por PCR fueron 1/5 y 1/10. Conclusiones: El ADN de B. bacilliformis extraído con DNAzol® BD de sangre total de pacientes con bartonelosis aguda es amplificado por PCR utilizando los primers 16S y 23S; es posible usar esta técnica para el diagnóstico etiológico rápido.