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Journal of Clinical Microbiology, Sep 1997, 2283-2287, Vol 35, No. 9
Copyright © 1997 by the American Society for Microbiology. All rights reserved.

Serological cross-reactions between Bartonella and Chlamydia species: implications for diagnosis

M Maurin, F Eb, J Etienne and D Raoult
Unite des Rickettsies, CNRS UPRESA 6020, Universite de la Mediterranee, Faculte de Medecine, Marseille, France.

Diagnosis of Chlamydia or Bartonella infections continues to rely mainly on serology. However, serological cross-reactions between members of these genera have recently been described. Sera from eight patients originally diagnosed as having Chlamydia pneumoniae endocarditis reacted with both Chlamydia sp. and Bartonella quintana antigens (microimmunofluorescence technique). Adsorption of sera with B. quintana or C. pneumoniae antigens removed anti-C. pneumoniae antibodies, whereas adsorption with C. pneumoniae antigens did not change antibody titers to B. quintana. Western blot analysis confirmed the presence of cross-reacting antigens and showed antibody patterns in all sera to be compatible with a Bartonella infection. These patients were therefore probably suffering from Bartonella-induced rather than Chlamydia-induced endocarditis. In contrast, sera from 10 patients presumed to be suffering from C. pneumoniae pneumonia did not display anti-B. quintana antibodies, although cross-reacting antigens were revealed by Western blotting. This work highlights the possibility that cases of infective Bartonella endocarditis are erroneously diagnosed as chlamydial infections.

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