Infectious Disease Compendium

Cat scratch fever

Diagnosis

A syndrome of fevers, regional lymphadenopathy.

Epidemiologic Risks

A cat scratch, while nice, is not a must; just being around the vermin may be enough.

Microbiology

B. henselae. Serology is unreliable.

Empiric Therapy

Trimethoprim/sulfamethoxazole OR azithromycin OR erythromycin OR doxycycline OR quinolone.

Specific Therapy

It's a self limited disease and the lymphadenopathy can take months to resolve, so response to antibiotics is hard to judge; 2 weeks po should suffice.

The majority of patients after a scratch will have symptoms (fatigue, arthralgias and myalgias, half of pateints will seroconvert and maybe a quarter will have evidence of a blood stream infection (PubMed).

Pearls

Can also cause an acute encephalitis and coma, that recovers spontaneously. I had one patient who had both of his girlfriends' cats put to death (the cats, not two girlfriends) after he had cat scratch encephalitis. Whether they are still together or not I do not know.

Rants

Cats really are vermin that serve no useful purpose but spread disease, or I have I said that before?

ICD9 Codes (Soon to be supplanted by ICD10)

078.3.