CAT SCRATCH DISEASE

Cat Scratch Disease : Cat Scratch Disease (CSD) is a self-limited condition transmitted by a Bartonella species (Rochalimaea henselae) present in unaffected kitten paws. Following inoculation by a scratch and one to two weeks of incubation period, malaise, fever, headache, anorexia and swelling of the regional lymph nodes follow.

The adenopathy generally develops in the upper extremity (epitrochlear, axilla) or head/neck areas, is minimally tender and can develop fluctuation. Median age is 14 years with highest attack rate in children less than ten years of age. The diagnosis relies on the presence of symptoms, signs, physical exam (characteristic papule at the site of the scratch), history of exposure to a cat, and a positive immunofluorescent assay for Bartonella antibodies.

Most patients with clinically diagnosed CSD developed an immunologic response to Bartonella species. Conservative symptomatic management is recommended for most children since the node will eventually disappear spontaneously. In other cases' aspiration of fluctuant nodes is alleviating. Antibiotics are recommended during severe cases. Overall prognosis is good.