Cat Scratch Disease

GENERAL INFORMATION:

What is cat-scratch disease? Cat-scratch disease, also called CSD, is an infection caused by being scratched, licked, or bitten by an infected cat. Kittens less than 12 months old and stray cats are more likely to cause CSD. This disease causes swelling of the lymph nodes. Lymph nodes are small rounded lumps of tissues that make up part of the immune system. The immune system helps the body fight infection and disease. Cat-scratch disease is more common during the fall and winter seasons. It often affects people under 21 years of age, especially children who are aged 2 to 14 years. CSD often causes mild problems but it can lead to serious problems in people with a weak immune system.

What causes cat-scratch disease? Cat-scratch disease is caused by a type of bacteria (germs) called Bartonella henselae. These germs may live in the saliva of infected cats without making them sick. Fleas spread the germs between cats, and these cats can pass them on to humans. The germs usually spread after the cat licks its paws then scratches or bites human skin. The germs may enter through your wound if an infected cat licks it. You may also get sick if you have other ways of close contact with the cat. Rubbing your eyes without washing your hands after holding a cat may also spread CSD.

What are the signs and symptoms of cat-scratch disease? You may see painless blisters or bumps along your wound 3 to 10 days after being bitten or scratched. Lymph nodes near the bitten or scratched area may become red, swollen, and painful 1 to 3 weeks later. These often include lymph nodes around the neck, armpit, and groin. Pus may also form within these lymph nodes. Other symptoms may include loss of appetite, rash, sore throat, headache, fever, and muscle, joint, or abdominal (stomach) pain.

How is cat-scratch disease diagnosed? Your caregiver will need to know if you have had any contact with a cat. He will closely look at your affected area to check for other problems. You may also have any of the following tests:

• Blood tests: You may need to have blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. These tests will look for the bacteria that causes CSD or for any antibodies against the bacteria. Antibodies are substances that the immune system makes to protect the body from outside invaders. It can give your caregivers more information about your health. You may need to have blood drawn more than once.
  
  
• Biopsy: For a biopsy, a small piece of tissue is taken from the infected area. This sample is then sent to the lab for tests. This helps caregivers learn what kind of infection you have.
  
  
• Culture: This is a test to grow and identify the germ that is causing your condition. Samples may be taken from your wound, blood, or lymph nodes.
  
  
• Imaging tests: Pictures of your bones, tissues, and organs may be taken using different imaging tests. Tests may include x-rays, ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI). Caregivers use the pictures to look for other problems to see how far the disease has reached.
  
  
• Skin test: A small amount of special liquid is injected just under your skin, usually on the forearm. This pushes a part of the skin so that a small lump is made. Your caregiver will mark this area. Your skin is then checked after 2 to 3 days for a reaction indicating CSD.

How is cat-scratch disease treated? Cat-scratch disease may go away within 2 to 4 months even without treatment. In some cases, you may need one or more of the following:

• Medicines: Your caregiver may give you antibiotic medicine to fight infection. You may also be given medicine to ease your symptoms, such as fever, pain, and swelling.
  
  
• Drainage: Caregivers may drain the fluid or pus that has collected in your lymph nodes. A needle may be used to suck the fluid out. Caregivers may also drain the pus by making an incision (cut) in the affected area.
  
  
• Surgery: Caregivers may remove all or part of your affected lymph nodes. This may be done if your condition lasts longer than normal.

How can cat-scratch disease be prevented?

• Always wash your hands after handling or petting your cat.
  
  
• Have your cat treated for fleas. This will help decrease the spread of bacteria that causes CSD among cats.
  
  
• If you have an open wound, do not allow your cat to lick it.
  
  
• Take care when playing with cats to avoid bites or scratches. Avoid rough play.
  
  
• You may have your kitten's claws cut.
  
  
• If you get scratched, licked, or bitten by a cat, wash the affected area with clean water and soap.

Where can I get more information? Contact the following for more information about cat-scratch disease:

• American Academy of Family Physicians
  PO Box 11210
  Shawnee Mission, KS 66207-1210
  Phone: 1-913-906-6000
  Web Address: http://www.aafp.org
  

• Centers for Disease Control and Prevention
  National Center for Infectious Diseases
  Phone: 1-888-4437232
  Web Address: http://www.cdc.gov/ncidod/
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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