Test ID: BART
Bartonella Antibody Panel, IgG and IgM, Serum
NY State Approved 
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Rapid diagnosis of Bartonella infection, especially in the context of a cat scratch or histopathology showing typical features of stellate microabscesses and/or positive Warthin-Starry stain
Method Name A short description of the method used to perform the test
Immunoflourescence Assay (IFA)
Includes Bartonella henselae and Bartonella quintana.
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Bartonella Quintana, IgG/IgM
Cat Scratch Disease Ab Panel, IFA, Serum
Rochalimaea
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Forms: If not ordering electronically, submit a General Request Form (Supply T239) with the specimen.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild OK; Gross reject |
| Lipemia | Mild OK; Gross reject |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 7 days |
| Frozen | 7 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Bartonella henselae and Bartonella quintana are small, rod-shaped, pleomorphic, gram-negative bacteria. The human body louse (Pediculus humanis) is the proposed vector for Bartonella quintana. No animal reservoir has been determined for Bartonella quintana. The domestic cat is believed to be both a reservoir and vector for Bartonella henselae. Cats may infect humans directly through scratches, bites, or licks or indirectly through an arthropod vector. Humans remain the only host in which Bartonella infection leads to significant disease.
The sight of entry for Bartonella is through openings in the skin. Microscopically, Bartonella lesions appear as rounded aggregates that proliferate rapidly. These aggregates are masses of Bartonella bacteria. Warthin-Starry staining has shown that Bartonella organisms can be present within the vacuoles of endothelial cells, in macrophages, and between cells in areas of necrosis. Occasionally organisms are seen in the lumens of vessels. While cutaneous lesions are common, disseminated tissue infection by Bartonella, has been seen in the blood, lymph nodes, spleen, liver, bone marrow, and heart.
Bartonella henselae has been associated with cat scratch disease (CSD), peliosis hepatitis (PH), and endocarditis.Bartonella quintana has been associated with trench fever, bacillary angiomatosis (BA), and endocarditis. Both can cause BA, a newly recognized syndrome. BA is a vascular proliferative disease usually involving the skin and regional lymph nodes.
CSD begins as a cutaneous papule or pustule that usually develops within a week after an animal contact. Regional lymphadenopathy, which follows, is the predominant clinical feature of CSD. Skin testing has been used in the past for CSD, but no skin test has been licensed for routine use.
Trench fever, which was a problem during World War I and World War II, is characterized by a relapsing fever and severe pain in the shins.
Interest in Bartonella quintana and Bartonella henselae has recently increased since its presence in AIDS patients and transplant patients has been documented. PH and febrile bacteremia syndrome are both syndromes that have afflicted patients with AIDS or those patients that are immunocompromised.
While trench fever and CSD are usually self-limiting illnesses, the other Bartonella-associated diseases can be life-threatening.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Bartonella henselae
IgG: <1:128
IgM: <1:20
Bartonella quintana
IgG: <1:128
IgM: <1:20
Interpretation Provides information to assist in interpretation of the test results
A positive Immunoflourescence assay (IFA) IgM (titer >1:20) suggests a current infection with either Bartonella henselae or Barteonella quintana.
A positive IgG (titer >1:128) suggests a current or previous infection. Increases in IgG titers in serial specimens would indicate an active infection.
Normal serum specimens usually have an IgG titer of <1:128. However, 5% to 10% of healthy controls exhibit a Bartonella henselae and Bartonella quintana titer of 1:128. No healthy controls showed titers of >or = 1:256. IgM titers from normal serum were found to be <1:20. IgM titers at >or = 1:20 have not been seen in the normal population.
Culture should also be considered, but this may not be an optimal method due to slow growth and fastidious nature of the organism.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
IgG cross-reactivity between Bartonella henselae and Bartonella quintana has been reported. However, the infecting species will usually have the higher titer.
IgM cross-reactivity is usually not seen. Significant cross-reactions have been reported between Bartonella species and Chlamydia species.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Maurin M, Raoult D: Bartonella (Rochalimaea) quintana infections. Clin Microbiol Rev 1996;9:273-292
2. Maurin M, Birtles R, Raoult D: Current knowledge of Bartonella species. Eur J Clin Microbiol Dis 1997;16:487-506
Method Description Describes how the test is performed and provides a method-specific reference
Immunofluorescence assay (IFA) technique using antigen substrate slides consisting of 2 separate cell cultures infected with Bartonella henselae or Bartonella quintana.(Maurin M, Raoult D: Bartonella [Rochalimaea] quintana infections. Clin Microbiol Rev 1996;9:273-292)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Saturday; 9 a.m.
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
86611 x 4
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| 15659 | Bart Henselae IgG | 6954-2 |
| 15660 | Bart Henselae IgM | 6955-9 |
| 15661 | Bart Quintana IgG | 44827-4 |
| 15662 | Bart Quintana IgM | 44825-8 |
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