Cat-Scratch Disease

Definition:
Cat-scratch disease is an infection caused by bacteria (germs) carried in cat saliva. The bacteria can be passed from a cat to a human. Doctors and researchers think cats may get the bacteria from fleas, although this hasn’t been proved.

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.You can get cat-scratch disease from a cat bite or cat scratch. You can get the infection after a cat scratches you if the cat’s paws have the bacteria on them. (A cat can get the bacteria on its paws when it licks itself.) With a cat bite, the cat can pass the bacteria to you in its saliva. You can also get the bacteria in your eyes if you pet a cat that has the bacteria on its fur and then rub your eyes. Many people who get cat-scratch disease do not remember being scratched or bitten by a cat.

Cat-scratch disease is not a severe illness in people who are healthy. But it can be a problem in people with weak immune systems. People with weak immune systems include those who are receiving chemotherapy for cancer, those who have diabetes or those who have acquired immunodeficiency syndrome (AIDS).

It is a bacterial disease caused by Bartonella henselae. Most people with CSD have been bitten or scratched by a cat and developed a mild infection at the point of injury. Lymph nodes, especially those around the head, neck, and upper limbs, become swollen. Additionally, a person with CSD may experience fever, headache, fatigue, and a poor appetite. Rare complications of B. henselae infection are bacillary angiomatosis and Parinaud’s oculolandular syndrome.


Other Names:

The condition has also been termed Cat-Scratch Adenitis, Cat-Scratch-Oculoglandular Syndrome, Debre’s Syndrome, Debre-Mollaret Syndrome, Foshay-Mollaret Cat-Scratch Fever, Foshay-Mollaret syndrome, Foshay-Mollaret Cat-Scratch Fever Syndrome, Lymphadenitis-Regional Non-bacterial, Lymphoreticulosis-Benign Inoculation, maladie des griffes du chat, Parinaud oculoglandular disease, and Petzetakis’ disease.CSD; Cat scratch fever; Bartonellosis

Transmission
The cat was recognized as the vector of the disease in 1950 by Dr. Robert Debré.

The causative organism was first thought to be Afipia felis, but this was disproved by immunological studies demonstrating that cat scratch fever patients developed antibodies to two other organisms, Bartonella henselae and Bartonella clarridgeiae, which are rod-shaped Gram negative bacteria.

Kittens are more likely to carry the bacteria in their blood, and are therefore more likely to transmit the disease than are adult cats.

Ticks are also a major transmitter of this disease. It is often transmitted at the same time a human may get Lyme Disease.

Causes :

Cat scratch disease is caused by Bartonella henselae. The disease is spread through contact with an infected cat (a bite or scratch), or contact with cat saliva on broken skin or the white of the eye.

About 2 – 3 weeks after becoming infection, lymph nodes swelling (lymphadenopathy) occurs near the site of the scratch or bite.

Occasionally, an infected lymph node may form a tunnel (fistula) through the skin and drain. Cat scratch disease is a common causes of chronic lymph node swelling in children.

Sign & Symptoms:

A person who has had contact with a cat may show common symptoms, including:

* Bump (papule) or blister (pustule) at site of injury (usually the first sign)
* Lymph node swelling near the scratch or bite
* Fever (in some patients)
* Fatigue
* Overall discomfort (malaise)
* Headache

Less common symptoms may include:

* Loss of appetite
* Weight loss
* Enlarged spleen
* Sore throat
* Draining lymph nodes
A sore may develop where a cat has bitten or scratched you. The sore might not happen right away. It may take 3 to 10 days for the sore to appear after the bite or scratch.

The sore may take a long time to heal. An infection of the lymph nodes (also called lymph glands) also develops, most often in the glands that are near the place where you got the cat scratch or cat bite. For example, if the infection is from a cat scratch on your arm, the glands in your armpit may become tender and swollen. The lymph nodes may swell to an inch or more in size.

Cat scratch fever presents with tender regional lymphadenopathy, sterile suppurative papules at the site of inoculation, slight fever, headache, chills, backache, abdominal pain, malaise, alteration of mental status, and convulsions. It may take 7 to 14 days, or as long as two months, before symptoms appear. Most cases are benign and self-limiting, but lymphadenopathy may persist for several months after other symptoms disappear. The prognosis is generally favorable. In temperate climates, most cases occur in fall and winter. The disease usually resolves spontaneously, with or without treatment, in one month. In immunocompromised patients more severe complications sometimes occur.

Exams and Tests :

A scratch or injury and a history of contact with a cat indicates that cat scratch disease is a possible cause of the lymph node swelling. In some cases, physical examination also shows an enlarged spleen (splenomegaly).

The disease often goes unrecognized because of the difficulty in testing. However, the Bartonella henselae IFA test is highly sensitive and specific for the detection of infection caused by this bacteria.

Other tests used in the diagnosis of cat scratch disease:

* Lymph node biopsy to rule out other causes of swollen glands

When to call a Doctor?
Call your family doctor if you notice any of the following problems:

* A cat scratch or bite that does not heal in the usual length of time.
* An area of redness around a cat scratch or bite that continues to get bigger for more than 2 days after the injury.
* Fever that lasts for several days after a cat scratch or bite.
* Painful and swollen lymph nodes for more than 2 or 3 weeks.
* Bone or joint pain, abdominal pain (without fever, vomiting or diarrhea) or an unusual degree of tiredness for more than 2 or 3 weeks.

 

Treatment:

In AIDS patients and in other people who have suppressed immune systems, cat scratch disease is more serious, and treatment with antibiotics is recommended.

Azithromycin, ciprofloxacin, doxycycline, and multiple other antibiotics have been used successfully.

In most people, cat-scratch disease clears up without treatment. However, antibiotics (medicines that kill bacteria) may be needed when infected lymph nodes stay painful and swollen for more than 2 or 3 months. Antibiotics may also help if you have a fever for a long time or if the infection is in your bones, liver or another organ.

If a lymph node is very large or painful, your doctor may drain it to help relieve the pain. The lymph node is drained by putting a needle through normal skin off to the side of the node and moving the needle to the swollen node. The needle is then inserted into the node and the fluid in the node is drained out.

Treatment for the cat:

Cats require no treatment. The bacteria doesn’t cause cats to get sick. They merely carry the bacteria that causes cat-scratch disease in people.

Resources:

http://familydoctor.org/online/famdocen/home/healthy/firstaid/bites/024.html

http://www.nlm.nih.gov/medlineplus/ency/article/001614.htm

http://en.wikipedia.org/wiki/Cat_scratch_fever

Prognosis:

In children with normal immune systems, full recovery without treatment is the norm. In immunocompromised people, treatment with antibiotics generally leads to recovery.

Possible Complications:

* Parinaud’s syndrome
* Encephalopathy
* Neuroretinitis
* Osteomyelitis


Prevention:

Avoiding contact with cats prevents the disease. Where this is not reasonable, good hand-washing after playing with a cat, avoiding scratches and bites, and avoiding cat saliva will lessen the risk of infection.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:

http://familydoctor.org/online/famdocen/home/healthy/firstaid/bites/024.html

http://www.nlm.nih.gov/medlineplus/ency/article/001614.htm

http://en.wikipedia.org/wiki/Cat_scratch_fever

 

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One thought on “Cat-Scratch Disease

  1. kay

    most likely i am suspected to carry this illness..so i started to find information about this illness. i found that this article is very helpful and help me to find the best way to solve the problem that i am having now. my hope is that this illness will fade away as i will going to have serious treatment to cure it and not to forget, a lot of thanks to whoever provide this helpful article.

    Reply

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