eMedicine Specialties > Emergency Medicine > Infectious Diseases

Catscratch Disease: Follow-up

Author: Erik D Schraga, MD, Consulting Staff, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates; Consulting Staff, Permanente Medical Group, Kaiser Permanente, Santa Clara Medical Center
Contributor Information and Disclosures

Updated: Mar 6, 2008

Follow-up

Further Inpatient Care

  • Immunocompetent patients and immunocompromised patients without evidence of systemic disease may be followed on an outpatient basis.

Further Outpatient Care

  • Patients should follow up in 2-6 months for confirmation of symptom resolution.
  • Disposal of the cat is not necessary, since its ability to transmit the organism is transient.

Prognosis

  • The prognosis for immunocompetent patients with CSD is excellent. Complete recovery without sequelae occurs in nearly all patients. Even in patients with CNS involvement, recovery without neurologic sequelae within weeks to months can be expected.
  • Patients who are immunocompromised are in jeopardy of systemic disease and resultant complications. However, with appropriate antibiotic use and management of complications, these patients also typically experience full resolution of disease.

Miscellaneous

Medicolegal Pitfalls

  • Failure to consider CSD as a possible diagnosis is a pitfall.
  • Although CSD neuroretinitis and encephalitis are self-limited and not life-threatening, other potentially serious etiologies must be ruled out.
  • Current recommendations generally favor treatment with antibiotics for CSD in an immunocompromised patient.

Special Concerns

  • Immunocompromised patients: Persons with AIDS or other immunocompromising conditions, such as alcoholism or use of immunosuppressive therapy, may experience more dramatic and often more atypical manifestations of CSD. Patients are at increased risk of systemic disease including encephalitis and fever with bacteremia. Treatment with antibiotics and close observation are indicated in this group of patients.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Rick Kulkarni, MD, to the development and writing of this article.



More on Catscratch Disease

Overview: Catscratch Disease
Differential Diagnoses & Workup: Catscratch Disease
Treatment & Medication: Catscratch Disease
Follow-up: Catscratch Disease
References
[ CLOSE WINDOW ]

References

  1. Jackson LA, Perkins BA, Wenger JD. Cat scratch disease in the United States: an analysis of three national databases. Am J Public Health. Dec 1993;83(12):1707-11. [Medline].

  2. Reynolds MG, Holman RC, Curns AT, O'Reilly M, McQuiston JH, Steiner CA. Epidemiology of cat-scratch disease hospitalizations among children in the United States. Pediatr Infect Dis J. Aug 2005;24(8):700-4. [Medline].

  3. Adal KA, Cockerell CJ, Petri WA. Cat scratch disease, bacillary angiomatosis, and other infections due to Rochalimaea. N Engl J Med. May 26 1994;330(21):1509-15. [Medline].

  4. Anbu AT, Foulerton M, McMaster P, Bakalinova D. Basal ganglia involvement in a child with cat-scratch disease. Pediatr Infect Dis J. Oct 2003;22(10):931-2. [Medline].

  5. Anderson BE, Neuman MA. Bartonella spp. as emerging human pathogens. Clin Microbiol Rev. Apr 1997;10(2):203-19. [Medline].

  6. Bass JW, Freitas BC, Freitas AD, et al. Prospective randomized double blind placebo-controlled evaluation of azithromycin for treatment of cat-scratch disease. Pediatr Infect Dis J. Jun 1998;17(6):447-52. [Medline].

  7. Bogue CW, Wise JD, Gray GF. Antibiotic therapy for cat-scratch disease?. JAMA. Aug 11 1989;262(6):813-6. [Medline].

  8. Carithers HA. Cat-scratch disease. An overview based on a study of 1,200 patients. Am J Dis Child. Nov 1985;139(11):1124-33. [Medline].

  9. Carithers HA. Cat-scratch disease; notes on its history. Am J Dis Child. Mar 1970;119(3):200-3. [Medline].

  10. Carithers HA. Diagnosis of cat-scratch disease. Pediatrics. Aug 1985;76(2):325-6. [Medline].

  11. Chomel BB, Kasten RW, Floyd-Hawkins K, et al. Experimental transmission of Bartonella henselae by the cat flea. J Clin Microbiol. Aug 1996;34(8):1952-6. [Medline].

  12. English CK, Wear DJ, Margileth AM, et al. Cat-scratch disease. Isolation and culture of the bacterial agent. JAMA. Mar 4 1988;259(9):1347-52. [Medline].

  13. Gerber MA. Bartonella species (cat-scratch disease, bacillary angiomatosis, bacillary peliosis). In: Long, ed. Principles and Practice of Pediatric Infectious Diseases. 2nd ed. 2003.

  14. Hajjaji N, Hocqueloux L, Kerdraon R, Bret L. Bone infection in cat-scratch disease: A review of the literature. J Infect. Nov 28 2006;[Medline].

  15. Hansmann Y, DeMartino S, Piemont Y, et al. Diagnosis of cat scratch disease with detection of Bartonella henselae by PCR: a study of patients with lymph node enlargement. J Clin Microbiol. Aug 2005;43(8):3800-6. [Medline].

  16. Infectious Diseases and Immunization Committee, Canadian Paediatric Society (CPS. Cat scratch disease: Diagnosis and management. Paediatr Child Health. 1997;2(4):275-8.

  17. Koehler JE, Glaser CA, Tappero JW. Rochalimaea henselae infection. A new zoonosis with the domestic cat as reservoir. JAMA. Feb 16 1994;271(7):531-5. [Medline].

  18. Little S. Cat Scratch Disease. Cat Fancier's Association [Web site]. Available at http://www.cfa.org/articles/health/csd.html.

  19. Margileth AM. Antibiotic therapy for cat-scratch disease: clinical study of therapeutic outcome in 268 patients and a review of the literature. Pediatr Infect Dis J. Jun 1992;11(6):474-8. [Medline].

  20. Regnery RL, Olson JG, Perkins BA, Bibb W. Serological response to "Rochalimaea henselae" antigen in suspected cat-scratch disease. Lancet. Jun 13 1992;339(8807):1443-5. [Medline].

  21. Rolain JM, Lepidi H, Zanaret M, et al. Lymph node biopsy specimens and diagnosis of cat-scratch disease. Emerg Infect Dis. Sep 2006;12(9):1338-44. [Medline].

  22. Tompkins LS. Bartonella Infections, including cat-scratch disease. In: Harrison's Textbook of Medicine. 16th ed. 2006.

  23. Vermeulen MJ, Herremans M, Verbakel H, Bergmans AM, Roord JJ, van Dijken PJ. Serological testing for Bartonella henselae infections in The Netherlands: clinical evaluation of immunofluorescence assay and ELISA. Clin Microbiol Infect. Jun 2007;13(6):627-34. [Medline].

  24. Wear DJ, Margileth AM, Hadfield TL, et al. Cat scratch disease: a bacterial infection. Science. Sep 30 1983;221(4618):1403-5. [Medline].

  25. Weiss EL. Wilderness-acquired zoonoses: cat-scratch disease. In: Wilderness Medicine. 4th ed. 2001:142-148.

  26. Zangwill KM, Hamilton DH, Perkins BA, et al. Cat scratch disease in Connecticut. Epidemiology, risk factors, and evaluation of a new diagnostic test. N Engl J Med. Jul 1 1993;329(1):8-13. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

CSD, cat-scratch disease, Parinaud oculoglandular disease, kitten scratch disease, la maladie des griffes du chat, benign inoculation lymphoreticulosis, benign inoculation reticulosis, catscratch fever, cat-scratch fever, regional granulomatous lymphadenitis, regional lymphadenopathy, regional lymphadenitis, conjunctival granuloma with conjunctivitis, suppurative preauricular adenitis,encephalopathy, erythema thrombocytopenic purpura nodosum, arthritis, synovitis, pneumonia, splenomegaly, pharyngitis, transient truncal maculopapular rash, preauricular adenopathy, encephalitis with seizures, facial nerveparesis,myelitis, neuroretinitis, polyneuritis, radiculitis, optic neuritis withtransient blindness, osteitis, osteomyelitis, hepatomegaly, hepatosplenomegaly with hepatic granulomata, erythema nodosum, erythema marginatum, erythema multiforme, Afipia felis, Afelis, Bartonella henselae, B henselae, Rochalimaea henselae, R henselae

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Erik D Schraga, MD, Consulting Staff, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates; Consulting Staff, Permanente Medical Group, Kaiser Permanente, Santa Clara Medical Center
Disclosure: Nothing to disclose.

Medical Editor

Jeffrey Glenn Bowman, MD, MS, Consulting Staff, Highfield MRI, Columbus, Ohio
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Barry J Sheridan, DO, Chief, Department of Emergency Medical Services, Brooke Army Medical Center
Barry J Sheridan, DO is a member of the following medical societies: American Academy of Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Jonathan Adler, MD, Attending Physician, Department of Emergency Medicine, Massachusetts General Hospital; Division of Emergency Medicine, Harvard Medical School
Jonathan Adler, MD is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine
Disclosure: eMedicine.com, Inc. Consulting fee Consulting

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.