Cat scratch disease is a bacterial infection that causes swelling
of the lymph nodes, and is due to a scratch, lick, or bite of a
cat. Ninety percent of the people that contact this disease get it
through a cat or kitten. This disease is known as Bartonella
henselae, and is found in all places of the world. There are about
22,000 cases of this disease reported in the United States every
year. Most often during the fall and winter and usually in kids
because they are most likely to play with cats and can be bitten or
scratched. Fleas spread the bacteria between cats, although there's
no evidence that fleas can transmit the disease to humans. The
bacteria live in infected cats' saliva but don't make the animals
sick; in fact, kittens or cats may carry the bacteria for months.
Experts believe that almost half of all cats have a Bartonella
henselae infection at some time in their lives, with those younger
than a year old are more likely to be infected. Signs and Symptoms
Here are some signs and symptoms to look out for: Many people with
cat scratch disease remember being around a cat, but often cannot
recall receiving a scratch or a bite. A blister or a small bump
develops several days after the scratch or bite and may be mistaken
for a bug bite. This blister or bump is called an inoculation
lesion (a wound at the site where the bacteria enter the body), and
it is most commonly found on the arms and hands, head, or scalp.
These lesions are generally not painful. Usually within a couple of
weeks of a scratch or bite, one or more lymph nodes close to the
area of the inoculation lesion will swell and become tender. (Lymph
nodes are round or oval-shaped organs of the immune system that are
often called glands.) For example, if the inoculation lesion is on
the arm, the lymph nodes in the elbow or armpit will swell. These
swollen lymph nodes appear most often in the underarm or neck
areas, although if the inoculation lesion is on the leg, the nodes
in the groin will be affected. They range in size from about ½ inch
to 2 inches in diameter and may be surrounded by a larger area of
swelling under the skin. The skin over these swollen lymph nodes
can become warm and red, and occasionally the lymph nodes drain
pus. In most kids, swollen lymph nodes are the main symptom of the
disease and the illness often is mild. If people have other general
symptoms, they might include fever (usually less than 101° F or
38.3° C ), fatigue, loss of appetite, headache, rash, sore throat,
and an overall ill feeling. Unusual cases do occur, but are
uncommon. In such cases, someone might have infections of the
liver, spleen, bones, joints, or lungs, or a lingering high fever
without other symptoms. Some get an eye infection (Parinaud
oculoglandular syndrome), with symptoms including a small sore on
the conjunctiva (the membrane lining the eye or inner eyelid),
redness of the eye, and swollen lymph nodes in front of the ear.
Others may develop inflammation of the brain or seizures. Although
this is rare. All of these complications of cat scratch disease
usually resolve without any lasting illness. Contagiousness Cat
scratch disease is not contagious from person to person. The
bacteria are spread by the scratch or bite of an infected animal,
most often a kitten. They can also be transmitted if the animal's
saliva comes in contact with an eye or through broken skin.
Sometimes multiple cases occur in the same family, usually via
contact with the same infected animal. Having one episode of cat
scratch disease usually makes people immune for the rest of their
lives. Prevention If you're concerned about cat scratch disease,
you do not need to get rid of the family pet. The illness is
relatively rare and usually mild, and a few steps can help limit
your kids' chances of contracting it. Teaching kids to avoid stray
or unfamiliar cats can reduce their exposure to sources of the
bacteria. To lower the risk of getting the disease from a family
pet or familiar cat, kids should avoid rough play with any pets so
they can avoid being scratched or bitten. Have your family members
wash their hands after handling or playing with a cat. If your
child is scratched by a pet, wash the injured area thoroughly with
soap and water. Keeping the house and your pet free of fleas will
reduce the risk that your cat could become infected with the
bacteria in the first place. If you suspect that someone caught cat
scratch disease from your family pet, don't worry that your cat
will have to be euthanized (put to sleep). Talk with your
veterinarian about how to handle the problem. Incubation and
Duration It usually takes 3 to 10 days for a blister or small bump
to appear at the site of a scratch or bite. Lymph node swelling
begins about 1 to 4 weeks later. The inoculation lesion where the
bacteria entered the body usually takes days to heal. The swollen
lymph nodes disappear within 2 to 4 months, although occasionally
last much longer. Treatment Doctors usually diagnose cat scratch
disease based on a child's history of exposure to a cat or kitten
and a physical examination. During the exam, the doctor will look
for signs of a cat scratch or bite and swollen lymph nodes. In some
cases, doctors use laboratory tests to help make the diagnosis,
including: skin tests, blood tests, and cultures to rule out other
causes of swollen lymph nodes a blood test that is positive for cat
scratch disease a microscopic examination of a removed lymph node
that shows signs of cat scratch disease. Most cases of cat scratch
disease resolve without any treatment. Rarely, a swollen lymph node
becomes so large and painful that the doctor may recommend removing
fluid from the node with a needle and syringe. Antibiotics
sometimes are used to treat the disease. If your doctor has
prescribed antibiotics, give them to your child on schedule and for
as many days as prescribed. Kids with cat scratch disease don't
need to be isolated from other family members. Bed rest is not
necessary, but can help if a child tires easily. If your child
feels like playing, encourage quiet play while being careful to
avoid injuring swollen lymph nodes. To ease sore nodes, try warm,
moist compresses or give your child nonprescription medicines like
acetaminophen or ibuprofen. When to Call the Doctor Call the doctor
whenever your child has swollen or painful lymph nodes in any area
of the body. And always call your doctor if a child is bitten by an
animal, especially if: the bite or scratch was from a cat and the
wound does not seem to be healing an area of redness around the
wound keeps expanding for several days. The child develops a fever
that lasts for a few days after receiving the scratch or bite. If
your child has already been diagnosed with cat scratch disease,
call the doctor if your child has a high fever, lots of pain in a
lymph node, seems very sick, or develops new symptoms. Conclusion
Cat scratch disease is not life threating, however, be sure to
observe the individual with the disease so that the signs don't
worsen and they take their medication as prescribed by a doctor.I
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