Cat Scratch Disease
Cat scratch disease (granuloma Mollare, cat scratch fever, lymphoreticulosis) is an acute infectious disease that occurs when cats bite, characterized by intoxication syndrome, an increase in lymph nodes located near the bite site.
ETIOLOGY
The causative agent of the disease is gram negative bacillus Bartonella. Natural reservoir – cats, dogs, small rodents, monkeys. At relatively low temperatures, it retains its viability well. When boiling, it is quickly inactivated. The source of the disease is infected animals. Most often, children and adolescents get sick because of closer contact with cats and dogs. After recovery, a long-lasting stable immunity is formed. The incubation period is 3-20 days.
You can get infected with close contact – not only a bite, scratch, but also blinding an infected animal.
RISK FACTORS:
Unvaccinated domestic cats, as well as suspicious street cats
Violation of cellular immunity, immunodeficiency
HIV
Long-term use of drugs: glucocorticosteroids, cytostatics
Alcoholism
symptoms
The disease develops, as a rule, gradually. A papule of a reddish color appears in place of a healed scratch, bite, and saliva. After some time, the papules turn into vesicles filled with serous or hemorrhagic fluid. Papules can fester a second time, heal, forming secondary elements – crusts that last for several days, then disappear. Scars do not form after the crusts fall off. 2-3 days after the healing of the crusts, regional lymphadenitis develops (inflammation of the lymph node). Along with this, intoxication syndrome develops, malaise, fever, and appetite decreases. The lymph nodes are somewhat enlarged in size, dense, slightly painful, in some cases the lymph nodes become inflamed and open, but more often they gradually resolve. Sometimes there is hepatosplenomegaly (enlargement of the spleen and liver). The recovery period is characterized by normalization of body temperature, disappearance of intoxication syndrome, the size of the liver and spleen come back to normal.
In some patients, the temperature rises 38-49 degrees and has a wave-like character with fluctuations in the morning and evening, and in the morning the temperature is higher, and in the evening it is almost within the normal range, which is an atypical sign. Rarely fever lasts up to 5-6 months. In some patients, the temperature is generally within the normal range.
Felinosis, as a form of the disease, can occur atypically – it passes under the mask of unilateral conjunctivitis, followed by an increase in the submandibular and parotid lymph nodes.
diagnostics
Since cat scratch disease has similar signs to plague, tularemia, mononucleosis, etc., differential diagnosis is necessary. Of particular importance is the epidemiological history (contact with cats, dogs, rodents).
Laboratory diagnostics – in clinical blood analysis of eosinophillia, increased ESR, serology – RSC, ELISA, PCR. The disease can also be detected by histological examination.
treatment
As a rule, cat scratch disease has a favorable outcome in the form of self-healing after 2 months. Of the etiotropic therapy, only Gentamicin, Ketolide has an effect. Inflamed lymph nodes are punctured, pus is removed, drained. Alternative drugs – Tetracycline, Chloramphenol, Ciprofloxacin.
PREVENTION
There is no specific prevention. Non-specific includes veterinary supervision of pets, timely and proper disinfection of bites and scratches (2% hydrogen peroxide rastovrom, then an alcoholic solution of aniline dyes (zelenka)).
