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Monday, March 17, 2014

Cat-Scratch Disease







  • This is a specific type of infection that results from the scratch of a cat.  It is caused by the bacterium, Bartonella henselae.
  • There is some evidence that other household pets can also cause cat-scratch disease.
  • Kittens appear to cause cat-scratch disease more commonly than adult cats, but it is not clear if this is because the bacterium is more common in kittens, or because children are more likely to play with (and, therefore, be scratched by) kittens and young cats.

  • Usually, but not always, the child or a caregiver will recall the Injury from the cat.
  • Occurs 2 days after scratch (present in 1/3 of patients):
  1. Infected scabbed ulcer
  2. Blister
  3. Blister with pus
  • Occurs 1-3 weeks after scratch:
  1. Fever
  2. Lack of energy
  3. Headache
  4. Swollen lymph glands
  5. Lymph glands may swell, become tender, or exude pus
  6. Rash

  • Scratch or Injury by a cat

  • Laboratory:
  1. Elevated white blood cell count
  2. Elevated sedimentation rate
  3. Biopsy of lymph nodes, if necessary, to rule out other causes

  • Presence of a young cat or kitten in the home.

  • None required for typical cat-scratch disease (resolves on its own in weeks to months)
  • Doxycycline, ciprofloxacin, or erythromycin for bacillary angiomatosis (see below)
  • Aminoglycosides for Encephalitis (brain infection)
  • The overwhelming majority of children with this disease do very well, and have no permanent complications.

  • Encephalitis (infection spreads to brain)
  • HIV infection may cause the infection to spread all over the body (called bacillary angiomatosis)

  • See your pediatrician for more information.

  • Children should be warned not to play too roughly with young cats and kittens.
  • Testing of kittens and cats for the infectious organism is not widely available, and, because of the relative rarity of this condition, not recommended.

  • Lymphoma
  • Cancer
  • Tuberculosis
  • Cellulitis
  • Abscess
  • Lymphogranuloma venereum

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