Cat Scratch Disease
What
is it?
Cat scratch disease is an infection that causes
swelling of the lymph nodes (swollen glands) after
an animal scratch - most often from a cat.
Who
gets it?
A child that has had exposure to a cat or
kitten.
What
causes it?
Bartonella henselae is the bacterium that
causes cat scratch disease. It is found in all
parts of the world, and over 80% of cases affect people
under age 21. Most cases occur in fall and winter.
In the United States, about 22,000 cases occur
annually. Worldwide, the disease affects nine out
of every 100,000 persons each year, and multiple
cases within families are common, especially among
those who have the same cat.
A cat with Bartonella henselae
infection does not look sick. Experts believe
that up to 44% of cats have a Bartonella henselae
infection at some time in their lives.
A blister or a small bump often develops 3 to
10 days after the scratch and may be mistaken for
an insect bite. The blister or bump at the site of
a cat scratch is called an inoculation lesion
(injury site where germs enter the body), and it
is most commonly found on the arms and hands,
head, and scalp.
What
are the symptoms?
In most children and adolescents, swollen lymph
nodes are the main symptom of the disease. About
one third of people with cat scratch disease have
other, more generalized symptoms. These include
fever (usually less than 101 degrees Fahrenheit or
38.3 degrees Celsius), fatigue, loss of appetite,
headache, and a generally "ill" feeling.
Very rarely, people with cat scratch
disease have symptoms that may include seizures.
These symptoms usually begin 1 to 6 weeks after
swollen lymph nodes appear and are severe for 1 to
2 weeks. People usually recover slowly, but
completely.
How
is it diagnosed?
The first clue to diagnosing this illness is
history of exposure to a cat or kitten. About 55%
to 70% of people with the infection have a cat
scratch somewhere on their bodies.
Usually within 2 weeks of a cat scratch, lymph
nodes close to the area of the inoculation lesion
will swell and become tender (lymph nodes are
bean-shaped organs of the immune system that are
often called glands).
These swollen lymph nodes or glands appear most
often in the underarm area, neck, and above the
collar bone. They range in size from about 1/2
inch to 2 inches (1 to 5 centimeters) in diameter and
may be surrounded by a larger area of swelling
under the skin. The swollen lymph nodes may also
be painful or tender, and the skin over them may
be red. Swollen lymph nodes may persist for
months.
What
is the treatment?
Antibiotics are generally used to treat the
disease, especially the unusual forms of cat
scratch disease. If your child's doctor has
prescribed antibiotics, give medication to your
child on schedule for as many days as your child's
doctor has advised. Use nonprescription medicines,
like acetaminophen, to relieve pain of swollen
lymph nodes and to lower fever.
In most cases, swollen lymph nodes usually
subside within 2 to 4 months. Rarely, a
swollen lymph node becomes so large and painful
that your child's doctor may recommend its
removal. This is usually done in a very simple
surgical procedure with a small incision.
Self-care
tips
Teaching children to avoid stray or unfamiliar
cats can prevent cat scratch disease. If your
child is scratched by a pet - even one of your own
household pets - wash the injured area thoroughly
with soap and water.
If you have a cat in your home, ask your
veterinarian's advice about having the cat
declawed. If you suspect that someone in your
family has caught cat scratch disease from your
family pet, you don't need to worry that the
animal will need to be put to sleep. Talk with
your veterinarian about the problem.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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