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Cat Scratch Disease

Cat Scratch Disease (also called Cat Scratch Fever or Bartonellosis) is a disease carried by cats that can affect humans, particularly children and young adults. It is caused by the rickettsia-like organism Bartonella henselae (formerly Rochalimaea henselae). This organism is commonly present in clinically normal cats around the world. There is no recognized clinical disease in cats. The infection can be transmitted to humans from cats by bites, scratches or licking an open wound.

There is estimated to be 25000 cases of Cat Scratch Disease per year in the United States, with about 2000 hospitalizations, but almost no fatalities. The disease is most frequently seen in people with close contact with a cat, especially children.

Affected humans have enlarged tender lymph nodes of unknown cause of several weeks duration. In 90% of cases there is a history of exposure to cats and of a bite, lick or scratch (usually from a kitten).

3 to 30 days after exposure the affected human develops a raised red sore at site of the bite or scratch. This occurs in 50% of cases. A regional lymphadenopathy (tender enlargement of the lymph nodes in the armpit, neck or groin ) commonly accompanied by malaise or fever appears 1 to 10 weeks after the scratch. The regional lymphadenopathy usually resolves within 4 to 6 weeks.

Less than 5% of people infected develop generalized signs including low grade fever, fatigue, headache and loss of appetite. Rarely, there is involvement of the spleen, brain, joints, eyes, lungs and other organs.

In immunosuppressed individuals the disease can be life threatening.

If you have cat scratch fever, consult your physician and follow his/her recommendations for diagnostic tests and treatment. Most patients will recover spontaneously within 2 to 3 months.

Prevention

Wash all bites and cat scratches promptly. Don't allow cats to lick open wounds.

References

Carlson DG & Giffin JM, Cat Owners Home Veterinary Handbook, New York: Howell Book House, 1995

Tilley LP & Smith FWK, The Five Minute Veterinary Consult - Canine and Feline (2nd Edition), Philadelphia: Lippincott Williams and Wilkins, 2000

Wilks CR & Humble MW, Zoonoses In New Zealand, Massey University, 1997

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