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cat-scratch disease

(CSD, felinosis, Teeny's disease) An infectious disease that most often results from a scratch or bite of a cat. It is more common in children. It is caused by Bartonella henselae spread by the cat's saliva. Young cats pose a greater risk than older cats. Occasionally, dog scratches or bites may be involved. B. henselae are excreted in the feces of Ctenocephalides felis (cat flea), with which cats can be infected through intradermal inoculation. Although, the fleas are also found on dogs. Incubation period is 3-14 days. (Symptoms) • non-painful blister or an erythematous papule at the site of injury • regional lymphadenopathy (most commonly in the axilla, arms, neck, or jaw): Painful and swollen lymph nodes. • tiredness • headache • fever (Complications) • meningoencephalitis • encephalopathy • seizures • endocarditis (high mortality) • Parinaud's oculoglandular syndrome: Combination of granulomatous conjunctivitis in the eye, and swollen lymph nodes in front of the ear on the same side. (most common ocular manifestation) • optic neuritis (atypical) • neuroretinitis (atypical) (Diagnosis) • polymerase chain reaction (PCR): Analysis of amplified DNA samples. • Warthin-Starry stain: A silver nitrate-based staining method. (Treatment) • Supportive care. • Antibiotics (e.g. azithromycin, doxycycline) for speed healing and patients with severe disease or immune problems. Doxycycline is preferred to treat the infections with optic neuritis, because it adequately penetrate the tissues of the eye and central nervous system. However, doxycycline has teratogenic side effects, therefore, azithromycin is preferentially used in pregnancy. Recovery typically occurs within 4 months but can require a year.