Cat-scratch disease

Cat-scratch disease (CSD) or bartonellosis is a disease caused by Bartonella henselae. There is also a possibility of transmission by ticks and fleas to humans, especially from cats and dogs. The disease usually affects cat breeders, people with immunodeficiency, polymorbid people or people living in poor hygiene conditions.

Clinical image
Papular lesions may appear approximately 5-10 days after being scratched or bitten by a cat or a tick bite. Accompanying phenomena may be malaise, fatigue, headache and subfebrile illness. Symptoms usually subside slowly within 2 months, but may be replaced by chronic problems. The disease can be accompanied by complications such as widespread infection, which is especially common in immunosuppressed individuals.
 * Only 10-20% of infections are symptomatic and occur below the picture of nodular syndrome with enlargement of the cervical and neck lymph nodes. The lymph nodules are often not very large.
 * In some cases, the number of affected lymph nodes may rarely occur.
 * Ocular form manifests itself as acute granulomatous uveitis or as acute  chorioretinitis. It usually takes the form of a unilateral acute or recurrent lesion.
 * Rarely, the central or peripheral nervous system, skin (rash, vasculitis), joints or other organs (hepatitis, myocarditis, pneumonitis are affected.

Diagnostics
Usually a clinical diagnosis is made, which can be supplemented with serology - imunofluorescence or ELISA. Bartonella are sensitive, require extended incubation time („chocolate“ agar). PCR can also be used for the assay.

In the blood count, there is leukocytosis, thrombocytopenia, anemia; serum alkaline phosphatase is elevated.

Treatment
Therapy consists of the administration of antibiotics - erythromycin, tetracycline, rifampicin.

Related articles

 * Bartonella henselae

Literature

 * GILLESPIE, SH a KB BAMFORD. Medical Microbiology and Infection at a Glance. 1. vydání. London : Blackwell Science, 2000. ISBN 978-1405111737.
 * BERAN, GW a KB BAMFORD. Handbook of Zoonoses, Section A: Bacterial, Rickettsial, Chlamydial and Mycotic. 2. vydání. Florida : CRC Press, 1994. ISBN 978-0849332050.
 * University of South Carolina. Microbiology and immunology online [online]. ©2007. Poslední revize 2009, [cit. 2009]. .