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Cat Scratch Disease (Bartonella Antibody) Test
What is Cat Scratch Disease? Cat
scratch disease is a bacterial infection that typically
causes swelling of the lymph nodes . It usually
results from the scratch, lick, or bite of a cat — more than 90% of people
with the illness have had some kind of contact with cats, often with kittens. Bartonella
henselae is the bacterium that causes cat scratch disease,
and it's found in all parts of the world. Cat scratch disease occurs more
often in the fall and winter. In the United States ,
about 22,000 cases are diagnosed annually, most of them in people under the
age of 21. This may be because children are more likely to play with cats
and be bitten or scratched. Fleas
spread the bacteria between cats, although currently there is no evidence
that fleas can transmit the disease to humans. Once a cat is infected, the
bacteria live in the animal's saliva. Bartonella henselae
does not make a cat sick, and kittens or cats may carry the bacteria
for months. Experts believe that almost half of all cats have a Bartonella
henselae infection at some time in their lives, and cats less than
1 year old are more likely to be infected. Signs
and Symptoms Most
people with cat scratch disease remember being around a cat, but often cannot
recall receiving a scratch or a bite. A blister or a small bump develops several
days after the scratch or bite and may be mistaken for an inset bite. This
blister or bump is called an inoculation lesion (a wound at the site where
the bacteria enter the body), and it is most commonly found on the arms and
hands, head, or scalp. These lesions are generally not painful. Usually
within a couple of weeks of a scratch or bite, one or more lymph nodes close
to the area of the inoculation lesion will swell and become tender. (Lymph
nodes are round or oval-shaped organs of the immune system that are often
called glands.) For example, if the inoculation lesion is on the arm, the
lymph nodes in the elbow or armpit will swell. These
swollen lymph nodes appear most often in the underarm or neck areas, although
if the inoculation lesion is on the leg, then the nodes in the groin will
be affected. They range in size from about ½ inch to 2 inches (1 to 5 centimeters)
in diameter and may be surrounded by a larger area of swelling under the skin.
The skin over these swollen lymph nodes may become warm and red, and occasionally
the lymph nodes drain pus. In
most children and adolescents, swollen lymph nodes are the main symptom of
the disease, and the illness often is mild. About one third of people with
cat scratch disease have other general symptoms. These include fever (usually
less than 101° Fahrenheit or 38.3° Celsius), fatigue, loss of appetite, headache,
rash, sore throat, and an overall ill feeling. Atypical
cases of cat scratch disease do occur, but they are much less common. In such
cases, a person may have infections of the liver, spleen, bones, joints, or
lungs, or a lingering high fever without any other symptoms. Some people get
an eye infection known as Parinaud oculoglandular syndrome
, with symptoms including: a small sore on the conjunctiva (the membrane
lining the eye or inner eyelid), redness of the eye, and swollen lymph nodes
in front of the ear. Others may develop inflammation of the brain or seizures,
although this is rare. All of these complications of cat scratch disease usually
resolve without any lasting illness.
It
typically takes 3 to 10 days for a blister or small bump to appear at the
site of a scratch or bite. Lymph node swelling usually begins about 1 to 4
weeks later. The
inoculation lesion where the bacteria entered the body usually takes days
to heal. The swollen lymph nodes typically disappear within 2 to 4 months,
although they occasionally last much longer. Contagiousness
Cat scratch disease is not contagious from person to person. The bacteria are spread by the scratch or bite of an infected animal, most often a kitten. They can also be transmitted if the animal's saliva comes in contact with broken skin or an eye. Sometimes multiple cases of the illness occur in the same family, but these likely result from contact with the same infected animal. Having
one episode of cat scratch disease usually makes people immune for the rest
of their lives. Prevention
Teaching
children to avoid stray or unfamiliar cats can reduce their exposure to sources
of the bacteria. To lower the risk of getting the disease from a family pet
or familiar cat, children should avoid rough play with any pets so they can
avoid being scratched or bitten. It is also a good idea for people to wash
their hands after handling or playing with a cat. If your child is scratched
by a pet, wash the injured area thoroughly with soap and water. Keeping the
house and your pet free of fleas will reduce the risk that your cat could
become infected with the bacteria in the first place. Professional
Treatment Doctors
usually diagnose cat scratch disease based on a child's history of exposure
to a cat or kitten, a physical examination and a conformatory lab test. During
the exam, a doctor will look for signs of a cat scratch or bite and swollen
lymph nodes. In some cases, doctors use laboratory tests to help make the
diagnosis, including:
When
to Call A Doctor Call
your child's doctor whenever your child has swollen or painful lymph nodes
in any area of the body, or if your child is ever bitten by an animal. You
should call if your child has been bitten or scratched by a cat and the
wound does not seem to be healing, an area of redness around the wound keeps
expanding for several days, or your child develops a fever that lasts for
a few days after receiving the scratch or bite. If your child has already been diagnosed with cat scratch disease, call the doctor if your child has a high fever, has lots of pain in a lymph node, seems very sick, or develops any new symptoms.
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