Serology and protein-based methods
IFA (immunofluorescence antibody assay) testing for the presence of antibodies in serum is used to diagnose B. henselae infection at the acute onset of Cat Scratch Disease symptoms, followed by PCR to confirm infecting species. IFA can generally be used to confirm a diagnosis of Bartonella infection, but is limited by antibody cross-reactivity with other bacteria species  which can cause a false positive, and antigen variability which can result in false negatives.Bartonella spp. often evade an immune response, thus antibodies may not be detected even concurrent with an infection, resulting in an IFA false negative rate of up to 83% in chronically infected patients when other test results (e.g. organism isolation or PCR) are positive. IFA sensitivity may range from 14 to 100%, causing discrepancies between PCR and serology test results. Positive IFA results do not distinguish between current infection and prior exposure.ELISA (enzyme-linked immunosorbent assay) is another method that has been used to detect Bartonella, but it has a low sensitivity (17-35%). Western blot for protein detection of Bartonella-associated proteins has also been reported, but this method does not show clear immunoreactive profiles. PCR
The CDC states that PCR testing from a single blood draw is not sufficiently sensitive for B. henselae testing, and can result in high false negative rates  due to a small sample volume and levels below the limit of molecular detection.Bartonella spp.
Trench fever
Detailed descriptions of the disease were reported in soldiers during the First World War. It is also known as five-day fever, quintan fever, Wolhinie fever, and urban trench fever, because it occurs in homeless people and alcoholics . References


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