| Disease/Syndrome |
Cat-scratch disease |
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| Category |
Infection, Occupational |
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| Acute/Chronic |
Acute-Moderate |
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| Synonyms |
Cat-scratch fever; Benign lymphoreticulosis; Bartonella henselae infection |
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| Biomedical References |
Search PubMed |
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| Comments |
This subacute infection is usually self-limited. A red papule can be found at the site of a cat bite, lick, or scratch in 50%-90% of cases. Lymphadenitis develops. Some patients have prolonged high fever and lesions of the bone, liver, and spleen. Neurological complications occur in some patients. Fleas are known to transmit the pathogen from cats to cats, but not from cats to humans. [CCDM, p. 90-2] In addition to regional lymphadenopathy, some patients have fever. Atypical presentations include conjunctivitis in 6% of patients and neurological complications (meningoencephalitis, myelitis, and neuritis) in 2% of patients. Granulomas of the spleen and liver have been reported. [Merck Manual, p. 1455-6] Other presenting symptoms compiled from several case series are fatigue (20-45%), splenomegaly (8-12%), and headache (13%). [ID, p. 1213, 1502] There are 3 main syndromes of cat-scratch disease: typical CSD (88%), Parinaud's oculoglandular syndrome (6%), and atypical CSD (6%). Patients with typical CSD have regional lymphadenopathy, and 1/3 of these patients have involvement at more than one site. Patients with typical CSD also have fever for several days (30% to 60%), fatigue (25%), and headache or sore throat (10%). Lymph nodes suppurate in about one sixth of patients. Atypical syndromes include hepatitis/splenitis, pneumonitis, osteitis, and neurologic syndromes (encephalopathy and neuroretinitis). Encephalopathy usually follows in cases with lymphadenopathy, and symptoms include persistent headache, combativeness, restlessness, seizures, nuchal rigidity, cranial nerve palsies, and ataxia. Fever may be present or absent. Encephalopathy is usually self-limited over several weeks to a year. Bartonella henselae is an important cause of neuroretinitis that usually resolves in 2-3 months. [PPID, p. 1417, 2736-40] |
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| Latency/Incubation |
3 days to 2 weeks from scratch to primary lesion; From 5 days to 1.5 months from scratch to lymphadenopathy; |
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| Diagnostic |
Greater than 1:64 titer by indirect immunofluorescence antibody (IFA) assay; immunodetection and PCR of tissue from lymph node biopsy; [CCDM, p. 90-1] |
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| ICD-9 Code |
078.3 |
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| Effective Antimicrobics |
Yes |
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| Reference Link |
Merck Manual - Cat-Scratch Disease |
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| Related Information in Haz-Map |
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| Symptoms/Findings |
Symptoms/Findings associated with this disease:
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| Job Tasks |
High risk job tasks associated with this disease:
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