Symptoms
Classic cat scratch disease first manifests as a red papule or pustule at the site where the cat scratched or bit. Soon, local lymphadenitis (inflammation and swelling of the lymph nodes) occurs on the side of the body with the injury, often on the armpit or neck. Children and adolescents are particularly affected. Other nonspecific complaints are observed, including:
- Deep fever
- Pain
- Fatigue
- Headache
- Sore throat
- Loss of appetite
- Nausea, vomiting
In an atypical course, the eyes, chest, liver and spleen, heart, lungs, bones, nervous system, meninges and other organs may be involved less frequently. Numerous clinical pictures, including severe ones, are possible. In immunosuppressed individuals, a severe and systemic course may occur (e.g., AIDS, use of immunosuppressants).
Causes
The disease is caused by the gram-negative, intracellular, aerobic bacterium and other bacteria of the genus. Up to half of all cats show antibodies against the pathogen, every tenth cat is said to carry the bacteria, in feral cats and feral cats the percentage is even higher (30%). The animals are healthy even if they are carriers of the bacterium.
Transmission
Transmission usually occurs from young domestic cats to humans, e.g., via bites, scratches, or when licking injured skin. The pathogens are found in cat saliva and in the feces of cat fleas, which are responsible for transmission between cats. Humans, on the other hand, are not contagious. It is known that less frequently other animals such as monkeys and dogs as well as ticks can pass on the infection. The disease appears on average within two weeks after the injury.
Diagonse
Diagnosis is made by medical treatment based on clinical signs and laboratory methods. History is important: Has there been contact with cats? Other diseases causing lymph node enlargement or nonspecific disease symptoms must be excluded.
Prevention
After an injury from cats, the wound should be well cleaned and disinfected. No vaccine is currently available. Immunocompromised individuals should not play with cats or reliably wean them of fleas. Wash hands well with soap and water regularly after contact with animals.
Treatment
The classic disease usually resolves on its own within about 2-6 months and is treated only symptomatically. Paracetamol, ibuprofen, or other pain relievers may be used to treat fever and pain. The inflamed and swollen lymph nodes are treated locally with cool compresses. Pain relief is also achieved by aspiration, in which fluid is drained from the nodes through a needle. Antibiotics are recommended only in complicated and severe disease. Medications considered appropriate in the literature include macrolides (azithromycin, clarithromycin), aminoglycosides (gentamicin), quinolones (ciprofloxacin), cotrimoxazole, and rifampicin.
