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CAT-SCRATCH FEVER

Cat-scratch fever, also known as cat-scratch disease (CSD), is a disease of humans caused by a pleomorphic gram negative bacteria.  The bacteria is dif­ficult to culture requiring special culture conditions. The organism is stained by War-thin-Starry silver stain and not by Gram stain.  The organ­ism can be detected in biopsy or needle aspirate material from affected tis.sues early in the disease.  Because of the difficulty in culturing the organism, diagnosis is based on 1) a history of exposure to a cat, 2) illness characterized by regionallymphadenitis, 3) other causes of 1ymphadenopathy having been excluded, 4) characteristic histopathology of a lymph node, 5) the presence of silver staining bacteria in biopsy material, and depending on availability, 6) a positive skin test with Hanger-Rose an-ti gen.

Cat scratch disease primarily affects children between the ages of 2-12 and is reported most often in the fall and win­ter months.  The role of the cat is unknown but it is sus­pected the organism is a com­mensal of the mouth, skin, or picked up on the paws from the environment.  The organism causes no signs of illness in cats and is most often associated with cats less than one year of age.  Infection by the CSD organism occurs common­ly from a scratch, puncture wound, or by the cat licking abraded skin.  Soon after the patient is scratched a red area develops which develops into a blister.  The blister ruptures, encrusts, and forms a papule up to 1 cm in diameter which lasts for several weeks.  The organ­ism is present in the papule. Regional1ymphadenopathy devel­ops 2-3 weeks after the initial exposure and glands become painful.  Most commonly, lymph nodes of the head, neck axil­lary and inguinal areas are affected.  In some cases lymph nodes are abscessed.  Usually 1ymphadenopathy resolves in 2-4 months although it may last for up to 2 years.  In a low number of patients conjunctival entry of the organism (probably caused by wiping the organism across the eyebrow by the hand) results in a soft granuloma or polyp developing on the eyelid. This is referred to as Parinaud'soculog1andu1arsyn­drome .

The CSD organism is present in healthy cats and is not highly infectious for all members of a household. Therefore, it 1s not necessary to remove the cat from the fam-ily.  Prevention of CSD can be achieved by declawing the cat, prompt washing of any scratches or wounds acquired while han­dling a cat, not allowing a cat to lick open wounds on a human, and washing hands well after handling a cat.  Antibiotics do not appear to shorten the course of the disease or to prevent abscessation of lymph nodes.  Suspected cases should be referred to a family physi­cian for proper diagnosis and medical attention.

Terry L.Bowersock,DVM,PhD Chief of Microbiology

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West Lafayette, IN 47907
Phone: 765-494-7440
Fax: 765-494-9181

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Dubois, IN 47527
Phone: (812) 678-3401
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