Cat scratch disease

Cat-scratch disease ( KKK ) is a disease of humans that is transmitted by scratch injury in cats. It is an infectious disease that is usually detected on the basis of lymph node swelling in the armpit or on the neck and runs usually benign. The cats are only carriers of the illness, but show on current knowledge, no signs of illness. Also in the cat flea, the causative agent of cat scratch disease are detectable. About him, the disease is probably transmitted from cat to cat.

Cause

The causative agent of the disease is Bartonella henselae, a gram-negative, rod-shaped bacterium. Another exciting Afipia felis is called. The pathogen is transmitted by the scratching of cats or their bite. In a series of patients but no contact with cats is detectable. Also, cat fleas can transmit the pathogen of cat scratch disease.

Synonyms ( other names )

Cat scratch fever; Katzenkratzlymphadenitis; in science use increasingly in the German cat scratch disease to be found in English or fever; benign inoculative lymphoreticulosis; Benign Inokulationslymphoretikulose; French Maladie the griffes de chat.

Dissemination

The disease may break out in children and in adults. Specifically, those with immunodeficiency sick faster. Although the cat scratch disease is spread worldwide, it is usually not recognized immediately as a specific blood test is necessary. If not this, the disease can not be clearly identified. The pathogen can be detected in 10-70 % of cats in Germany. A familial occurrence of the disease can be triggered by a newly acquired cat. Transmission from person to person has not been previously described. The disease is not notifiable.

Symptoms

After two to ten days may occur at the contact wound to a red - brown papule. These papules do not cause pain and disappear after a few days or weeks spontaneously. A little later the wound swelling of lymph nodes are then detectable in lymphatic drainage, which can be painless or painful. In some cases there is purulent melting down of the lymph nodes. The lymph nodes can remain enlarged for weeks.

There are severe atypical forms of the disease with high fever, body aches and headaches. Especially in a weakened body defenses may lead to an involvement of the central nervous system or sepsis.

Complications

Complications are especially inflammation of the central nervous system such as encephalitis, polyneuritis and radiculitis with paralysis and neuro-retinitis. Other organs and organ systems such as skeletal ( osteomyelitis), lungs (pneumonia), heart ( endocarditis), liver ( peliosis hepatis ) and blood vessels ( bacillary angiomatosis ) may be affected. In the blood hemolysis and thrombocytopenia may occur.

In addition, there may be a generalized spread of the skin papules.

Diagnostics

  • A history of contact with cats
  • Henselae antibody detection in blood against B.
  • Polymerase chain reaction (PCR ) for the detection of genomic Bartonella henselae DNA
  • Ultrasound examination of lymph nodes
  • Nonspecific increase in inflammatory markers: CRP, leukocyte
  • Biopsy or Feinnadelzytologie from a lymph node histological granulomatous inflammation with central necrosis

Differential diagnosis

  • Lymphadenitis by other agents: Lymph node involvement by mycobacteria, in particular by tuberculosis
  • Infectious mononucleosis
  • Cytomegalovirus infection
  • Acute HIV infection
  • Toxoplasmosis
  • Secondary syphilis
  • Lymphogranuloma venereum
  • Actinomycosis
  • Brucellosis
  • Tularemia

Therapy

In the majority of instances, the disease also heals without therapy. If this is not the case, an antibiotic treatment has to be carried out. Positive results have been achieved with azithromycin. But other antibiotics are likely to be effective.

Micrograph Axilla C-reactive protein Lymphadenopathy
115641
de