Catscratch Disease

Key Points
Infectious disease caused by the bacteria Bartonella
Caused when bacteria enters the bloodstream through the scratch of a cat
Cutaneous presentation

Catscratch disease, or cat scratch fever, is an often benign infectious disease transmitted to humans when the bacteria Bartonella enters the bloodstream via the scratch of a cat or the bite of a tick carrying the bacteria. Symptoms include swelling of the lymph nodes, and in some patients fever, headache, chills, and body pain. Cutaneous symptoms include a papule at the site of infection, and in rare cases rashes can develop. In specific cases, atypical symptoms may develop. Atypical symptoms can include prolonged fever, vision loss, joint pain, respiratory distress, seizures, and encephalitis.

Catscratch disease can affect anyone, though it is most commonly found in children. Persons with weakened immune systems, such as those with HIV, are very vulnerable to the disease and can experience atypical symptoms. The disease can be life-threatening in these cases.

Differential Diagnosis (Other conditions with similar appearance)

Brucellosis
Syphilis
Plague
Lyme disease
Lymphogranuloma venereum
Toxoplasmosis
Mononucleosis
Tuberculosis
Sarcoidosis

Diagnosis
Key Points
Diagnosis based on specific combination of symptoms
Serologic testing will be performed to confirm diagnosis and rule out similar appearing conditions

Catscratch disease is diagnosed based on a specific combination of symptoms, notably the presence of a papule at the transmission site and swelling of the lymph nodes. Diagnosis is confirmed with serologic testing.

Treatment
In most cases, the condition resolves in 2-4 months with minimal treatment
Goal of treatment is to alleviate symptoms and discomfort
In severe cases, antibiotics may be prescribed to relieve severe lymph node swelling, and must be prescribed in immune-compromised persons to prevent systemic disease and bacteremia

As most cases of Catscratch disease are self-limiting, extensive treatment is not required, and the disease will resolve in 2-4 months. In cases with severe pain related to swollen lymph nodes, health care professionals may perform a needle aspiration, relieving pressure. Additionally, short courses of antibiotics can assist in reducing lymph node swelling. In severe cases and cases where the affected person is immune-deficient, Antibiotics are often used to prevent the disease from becoming systemic and to prevent the development of bacteremia.