87471 Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique

Name of the Procedure:

Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique

Summary

This procedure involves using an advanced laboratory technique to detect the presence of Bartonella henselae and Bartonella quintana, bacteria that can cause various infections. The technique amplifies the bacterial DNA or RNA, making it easier to identify even small amounts of the bacteria in the patient's sample.

Purpose

The procedure is used to diagnose infections caused by Bartonella henselae and Bartonella quintana, such as Cat Scratch Disease or Trench Fever. The goal is to accurately detect the presence of these bacteria, enabling appropriate treatment.

Indications

• Unexplained fever or symptoms of infection.
• Swollen lymph nodes, particularly after a cat scratch or bite.
• Symptoms suggestive of Trench Fever, especially in individuals with risk factors like homelessness or alcohol abuse.
• Patients with symptoms consistent with Bartonella infection but without a confirmed diagnosis from other tests.

Preparation

• No specific preparation is typically required from the patient.
• Healthcare providers may ask about recent illnesses, animal contact, especially with cats, and travel history.
• A blood sample will be collected, which is a routine procedure.

Procedure Description

1. A healthcare provider takes a blood sample from the patient.
2. The sample is processed and sent to a laboratory.
3. In the laboratory, the sample undergoes a nucleic acid amplification procedure. This involves:
   • Extracting DNA or RNA from the blood sample.
   • Using probes that bind specifically to Bartonella henselae and Bartonella quintana DNA/RNA.
   • Amplifying these genetic materials to detectable levels.
4. Specialized equipment and reagents are used to identify the presence of the bacteria.

Duration

The blood draw takes a few minutes. The laboratory analysis may take several days to a week, depending on the processing time and lab workload.

Setting

• The blood draw can occur in a doctor’s office, hospital, or outpatient clinic.
• The laboratory analysis takes place in a specialized medical laboratory.

Personnel

• A phlebotomist or nurse performs the blood draw.
• Medical laboratory technologists or technicians conduct the laboratory analysis.

Risks and Complications

• Minor risks include pain, bruising, or infection at the site of the blood draw.
• Rarely, there could be inaccurate results due to sample contamination or technical issues.

Benefits

• Accurate diagnosis of Bartonella infections.
• Enables appropriate and timely treatment, potentially reducing complications.

Recovery

• There is no recovery period needed from the blood draw itself.
• Patients can resume normal activities immediately after the sample is collected.

Alternatives

• Serological tests (antibody detection) for Bartonella.
  • Pros: May be quicker depending on the lab.
  • Cons: Less specific and accurate than nucleic acid amplification.
• Empirical treatment based on clinical symptoms.
  • Pros: Immediate start of treatment if suspicion is high.
  • Cons: Lacks the precision of targeted diagnosis.

Patient Experience

• The patient will experience a standard blood draw procedure, which includes a brief needle prick.
• Mild discomfort or bruising at the puncture site is possible.
• No sedation or anesthesia is needed.

Pain management and comfort measures include properly preparing the skin and using a small needle. If the patient is anxious or uncomfortable, the healthcare provider can offer reassurance and support.