Cat-scratch disease: Difference between revisions
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**Adult (>45kg): [[Azithromycin]] 500mg PO x1, then 250mg/day x 4 days | **Adult (>45kg): [[Azithromycin]] 500mg PO x1, then 250mg/day x 4 days | ||
**Child (<45kg): [[Azithromycin]] 10mg/kg x1, then 5mg/kg per day x 4 days | **Child (<45kg): [[Azithromycin]] 10mg/kg x1, then 5mg/kg per day x 4 days | ||
===Antibiotic Dosing=== | |||
*{{AntibioticDose|drug=Rifampin|dose=300mg PO or IV q12h plus [[doxycycline]]|context=Bartonellosis|disease=Cat-scratch disease|population=Adult}} | |||
Latest revision as of 10:58, 20 March 2026
Background
- Caused by Bartonella henselae
Clinical Features
- History of cat (normally kitten) exposure
- Most commonly present about 2 weeks after exposure
- Lymphadenitis proximal to exposure
Parinaud's oculoglandular syndrome
- Due to direct inoculation of the eye
- Causes conjunctivitis, ocular granuloma, periauricular adenopathy
Differential Diagnosis
Lymphadenitis
Infectious
- Reactive adenitis
- Bacterial lymphadenitis
- Tuberculous lymphadenitis
- Cellulitis
- Cat-scratch disease
- Parotitis
- Lymphangitis
- Toxoplasmosis
- Tularemia
- Viral disease
- Fungal disease
- Reactive adenitis
Non-Infectious
- Malignancy
- Lymphoma
- Metastatic cancer
- Rheumatologic Disease
- Kawasaki Disease
- Systemic lupus erythematosus
- Sarcoidosis
- Juvenile Idiopathic Arthritis
- Langerhans Cell Histiocytosis
- Cutaneous Lesions:
- Bacillary angiomatosis
- Purpura
- Hematomas
- Angiomas
- Dermatofibromas
- Nevi
- Drug reaction
- Postvaccination
- Sarcoidosis
- Salivary gland diagnoses
Evaluation
Work-up
- Indirect fluorescence assay (IFA) or ELISA testing
Diagnosis
- Generally clinical diagnosis
Management
- Immunocompetent
- Adult (>45kg): Azithromycin 500mg PO x1, then 250mg/day x 4 days
- Child (<45kg): Azithromycin 10mg/kg x1, then 5mg/kg per day x 4 days
Antibiotic Dosing
- Rifampin 300mg PO or IV q12h plus doxycycline
Antibiotic Dosing
- Rifampin 300mg PO or IV q12h plus doxycycline
Antibiotic Dosing
- Rifampin 300mg PO or IV q12h plus doxycycline
Disposition
- Admit if immunocompromised or evidence of systemic disease.
- Otherwise discharge with PCP follow-up.