Cat-scratch disease

Background
  • Caused by Bartonella henselae

Clinical Features
Enlarged lymph node in axilla with cat scratch on hand.
  • History of cat (normally kitten) exposure
  • Most commonly present about 2 weeks after exposure
  • Lymphadenitis proximal to exposure

Parinaud's oculoglandular syndrome
  • Due to direct inoculation of the eye
  • Causes conjunctivitis, ocular granuloma, periauricular adenopathy

Differential Diagnosis


Evaluation

Work-up
  • Indirect fluorescence assay (IFA) or ELISA testing

Evaluation
  • Generally clinical diagnosis

Management
  • Immunocompetent
    • Adult (>45kg): Azithromycin 500mg PO x1, then 250mg/day x 4 days
    • Child (<45kg): Azithromycin 10mg/kg x1, then 5mg/kg per day x 4 days

Disposition
  • Admit if immunocompromised or evidence of systemic disease.
  • Otherwise discharge with PCP follow-up.

See Also


References
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