Cat-scratch disease
| Cat scratch disease | |
|---|---|
| Synonyms | cat-scratch fever, Teeny's disease, inoculation lymphoreticulosis, subacute regional lymphadenitis |
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| Micrograph of a lymph node affected by cat scratch disease. H&E stain. | |
| Classification and external resources | |
| Specialty | Infectious disease |
| ICD-10 | A28.1 |
| ICD-9-CM | 078.3 |
| DiseasesDB | 2173 |
| MedlinePlus | 001614 |
| eMedicine | emerg/84 |
| Patient UK | Cat-scratch disease |
| MeSH | D002372 |
Cat-scratch disease (CSD) is a common and usually benign infectious disease caused by the bacterium Bartonella henselae. It is most commonly found in children following a scratch or bite from a cat within about one to two weeks.
Cat-scratch disease commonly presents as tender, swollen lymph nodes near the site of the inoculating bite or scratch or on the neck, and is usually limited to one side. This condition is referred to as regional lymphadenopathy and occurs 1–3 weeks after inoculation. Lymphadenopathy in CSD most commonly occurs in the arms, neck, or jaw, but may also occur near the groin or around the ear. A vesicle or an erythematous papule may form at the site of initial infection. Most patients also develop systemic symptoms such as malaise, decreased appetite, and aches. Other associated complaints include headache, chills, muscular pains, joint pains, arthritis, backache, and abdominal pain. It may take 7 to 14 days, or as long as two months, for symptoms to appear. Most cases are benign and self-limiting, but lymphadenopathy may persist for several months after other symptoms disappear. The disease usually resolves spontaneously, with or without treatment, in one month.
In rare situations, CSD can lead to the development of serious neurologic or cardiac sequelae such as meningoencephalitis, encephalopathy, seizures, or endocarditis. Endocarditis associated with Bartonella infection has a particularly high mortality.Parinaud's oculoglandular syndrome is the most common ocular manifestation of CSD, and is a granulomatous conjunctivitis with concurrent swelling of the lymph node near the ear.Optic neuritis or neuroretinitis is one of the atypical presentations.
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