Cat-scratch disease is a common infection that usually presents as tender lymphadenopathy. It should be included in the differential diagnosis ...Advertisement<< PreviousarticleNextarticle >>Jan15,2011Issue  Cat-scratchDisease STEPHENA.KLOTZ,MD;VOICHITAIANAS,MD;andSEANP.ELLIOTT,MD,UniversityofArizona,Tucson,ArizonaAmFamPhysician. 2011 Jan 15;83(2):152-155. Patientinformation:Seerelatedhandoutoncat-scratchdisease.AbstractClinicalPresentationDiagnosticTestingTreatmentReferencesArticleSectionsAbstractClinicalPresentationDiagnosticTestingTreatmentReferencesCat-scratchdiseaseisacommoninfectionthatusuallypresentsastenderlymphadenopathy.Itshouldbeincludedinthedifferentialdiagnosisoffeverofunknownoriginandanylymphadenopathysyndrome.Asymptomatic,bacteremiccatswithBartonellahenselaeintheirsalivaserveasvectorsbybitingandclawingtheskin.Catfleasareresponsibleforhorizontaltransmissionofthediseasefromcattocat,andonoccasion,arthropodvectors(fleasorticks)maytransmitthediseasetohumans.Cat-scratchdiseaseiscommonlydiagnosedinchildren,butadultscanpresentwithitaswell.Thecausativemicroorganism,B.henselae,isdifficulttoculture.Diagnosisismostoftenarrivedatbyobtainingahistoryofexposuretocatsandaserologictestwithhightiters(greaterthan1:256)ofimmunoglobulinGantibodytoB.henselae.Mostcasesofcat-scratchdiseaseareself-limitedanddonotrequireantibiotictreatment.Ifanantibioticischosen,azithromycinhasbeenshowninonesmallstudytospeedrecovery.Infrequently,cat-scratchdiseasemaypresentinamoredisseminatedformwithhepatosplenomegalyormeningoencephalitis,orwithbacillaryangiomatosisinpatientswithAIDS.Cat-scratchdisease(CSD)isthemostcommonhumaninfectioncausedbyBartonellaspecies.CSDhasworldwidedistributionandhasbeendescribedinallareasofNorthAmerica.Innortherntemperatezones,itoccursmoreofteninAugustthroughOctober,usuallyinhumid,warmlocales.Thereareanestimated22,000newcasesofCSDperyearintheUnitedStates.1BartonellahenselaeisthemicroorganismresponsibleforCSD.Itisfoundinfelineerythrocytesandfleas,whichcancontaminatesa