CAT SCRATCH DISEASE
Category: Pediatric Surgery
Abstract : 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 extr
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.
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