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Cat scratch disease
Definition Cat scratch disease is an infectious illness caused by the bacteria bartonella. It is believed to be transmitted by cat scratches, bites, or exposure to cat saliva. Alternative Names CSD; Cat scratch fever; Bartonellosis Causes, incidence, and risk factors Cat scratch disease is caused by Bartonella henselae. The disease is spread through contact with an infected cat (a bite or scratch), or contact with cat saliva on broken skin or the white of the eye. About 2 - 3 weeks after becoming infection, lymph nodes swelling (lymphadenopathy) occurs near the site of the scratch or bite. Occasionally, an infected lymph node may form a tunnel (fistula) through the skin and drain. Cat scratch disease is a common causes of chronic lymph node swelling in children. Symptoms A person who has had contact with a cat may show common symptoms, including: - Bump (papule) or blister (pustule) at site of injury (usually the first sign)
- Lymph node swelling near the scratch or bite
- Fever (in some patients)
- Fatigue
- Overall discomfort (malaise)
- Headache
Less common symptoms may include: - Loss of appetite
- Weight loss
- Enlarged spleen
- Sore throat
- Draining lymph nodes
Signs and tests A scratch or injury and a history of contact with a cat indicates that cat scratch disease is a possible cause of the lymph node swelling. In some cases, physical examination also shows an enlarged spleen (splenomegaly). The disease often goes unrecognized because of the difficulty in testing. However, the Bartonella henselae IFA test is highly sensitive and specific for the detection of infection caused by this bacteria. Other tests used in the diagnosis of cat scratch disease: - Lymph node biopsy to rule out other causes of swollen glands
Treatment Generally, cat scratch disease is not serious. Medical treatment is not usually needed. However, in severe cases, treatment with antibiotics can be helpful. In AIDS patients and in other people who have suppressed immune systems, cat scratch disease is more serious, and treatment with antibiotics is recommended. Expectations (prognosis) In children with normal immune systems, full recovery without treatment is the norm. In immunocompromised people, treatment with antibiotics generally leads to recovery. Complications - Parinaud's syndrome
- Encephalopathy
- Neuroretinitis
- Osteomyelitis
Calling your health care provider Call your health care provider if you have enlarged lymph nodes and a history of exposure to a cat. Prevention Avoiding contact with cats prevents the disease. Where this is not reasonable, good hand-washing after playing with a cat, avoiding scratches and bites, and avoiding cat saliva will lessen the risk of infection. Review date: 8/6/2007 Reviewed By: D. Scott Smith, MD., MSc., DTM., Prof. Medical Microbiology & Immunology, Dept. of Human Biology, Stanford Univ. School of Medicine, Stanford, CA. Review provided by VeriMed Healthcare Network.
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