What is the role of stains in the diagnosis of bartonellosis (Bartonella infection)?

Updated: Jun 19, 2019
  • Author: Kassem A Hammoud, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Microscopic examination of Giemsa-stained blood smears is used to detect B bacilliformis in patients who may have Oroya fever.

Organisms are rod-shaped and slightly curved, similar to Campylobacter or Helicobacter species.

B bacilliformis organisms often appear to be adherent to erythrocytes, but they may actually be inside erythrocytes.

Other Bartonella species are visible only with silver stains (eg, Warthin-Starry, Steiner, Dieterle), if they stain at all. Bacillary forms also exist. These stains are not specific.

Immunostaining can also aid in the diagnosis of early lesions or atypical manifestations of catscratch disease. Capnetti at al [35] found that immunohistochemical analysis was positive in 25% of cases, PCR in 38% of cases, and Steiner silver stain in 46% of cases of 22 patients with lymphadenopathy and histopathological findings compatible with catscratch disease.

Late in the course of B henselae infection, organisms may not be found in areas of necrotizing granulomas.


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