Cat Scratch Disease, Bartonellosis

Cat scratch disease affects over 20,000 people each year. People, especially children and young adults present with enlarged tender lymph nodes of unknown cause of several weeks duration.

The majority of cases are believed to be caused by a rickettsial organisms called Rochalimaea henselea. A smaller number of cases may be caused by a bacteria named Afipia felis. Both have been found in infected tissue of people with cat scratch disease.

The cat, which is a carrier of the infection, is able to transmit the disease to humans during a two or three week period. In 90% of the cases people have been bitten, licked or scratched by a cat or a kitten. This means that the infective organism is carried in the cat's mouth and may be transferred to its claws during self-grooming.

Three to 10 days after exposure, a raised red sore develops at the site of transmittal. This occurs in about 50% of the cases. There may be a red streak up the arm or leg. In all cases there is tender enlargement of lymph nodes in the armpit, neck or groin. This condition may persist for two to five months.

Signs and Symptoms of Cat Scratch Disease

About 5% of those infected develop low grade fever, fatigue, headache and loss of appetite. In rare cases the spleen, brain, joints, eyes, lungs and other organs may be involved. In people with other serious health conditions this infection may be life-threatening.

Recently, there have been multiple cases of infection by microorganisms called Bartonella henselae and Bartonella clarridgeiae. Early symptoms may include fever, weight loss, excessive sweating, chills, and painfully enlarged lymph nodes. These may be followed by inflammation of the eye and subsequent retinal detachment that may result in neuroretinitis with partial or total loss of vision. All people infected by Bartonella had a history of cat scratch or bite.

Diagnosis of Cat Scratch Disease

Since the causative bacteria cannot be easily cultured from human lymph node samples, the diagnosis relies on multiple tests, including testing for Bartonella antibodies and detection of Bartonella DNA in patients' samples.

Treatment of Cat Scratch Disease

Consult your doctor and follow her or his recommendations for diagnostic tests and treatment. In case of infections caused by Bartonella (bartonellosis), you may require up to 6 months of treatment to improve your visual acuity.

In case of bartonellosis, the long-term progression is usually good, but urgent medical treatment is essential.

Prevention of Cat Scratch Disease

Many infected cats do not show signs of illness, but some develop fever, lethargy, swollen lymph glands, inflamed eyes and gums, and neurological disease, requiring treatment by a veterinarian. Cat owners should use a good flea control, keep cats' claws trimmed short, and discourage rough play to prevent scratches and bites. If you are bitten or scratched, wash the area immediately with soap and water. Do not let cats, or any animal, lick open wounds on your body. If one family member becomes infected, quarantine the cat for 2 to 3 weeks to prevent it from infecting others. A a precaution, sick children and immunodeficient individuals should avoid contact with cats under one year of age.