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Cat Scratch DiseaseAka: Cat-Scratch Disease

Epidemiology
1. Most common in young patients
2. Age under 21 years in 80% of cases
Etiology
1. Rochalimaea henselae (Gram Negative Rod)
Signs
1. Cat scratch or bite
  1. Local Papule, Pustule or Vesicle overlying scratch
2. Persistent painful Regional Lymphadenopathy
  1. Overlying reddened skin
  2. Lymph nodes fluctuant but sterile
Complications (2%)
1. Neurologic involvement
2. Liver or spleen involvement
3. Bone involvement
4. Further skin involvement
Lab
1. Skin test with antigen (Hanger-Rose skin test)
2. Anti-Bartonella henslae IgM titers
  1. Indicates acute infection in last 3 months
  2. Low Test Sensitivity (53%)
  3. IgG titers are not clinically useful
3. Excisional Biopsy
  1. Pleomorphic intracellular Rods
  2. Warthin-Starry silver impregnation stain
Management (May require 28 days of antibiotics)
1. Ampicillin
2. Second generation Cephalosporin
3. Third generation Cephalosporin
Course
1. Spontaneous resolution common

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 5/10/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.