Cat-scratch disease: Difference between revisions
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==Background== | ==Background== | ||
*Caused by Bartonella henselae | *Caused by [[Bartonella henselae]] | ||
==Clinical Features== | ==Clinical Features== | ||
* | [[File:Cat-scratch disease lesion.jpg|thumb|A lesion on the hand of a person with cat-scratch disease.]] | ||
[[File:Cat-scratch-disease.jpg|thumb|Enlarged lymph node in axilla with cat scratch on hand.]] | |||
*History of cat (normally kitten) exposure | |||
*Most commonly present about 2 weeks after exposure | |||
*Lymphadenitis proximal to exposure | *Lymphadenitis proximal to exposure | ||
===Parinaud's oculoglandular syndrome=== | |||
* | *Due to direct inoculation of the eye | ||
*Causes conjunctivitis, ocular granuloma, periauricular adenopathy | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Lymphadenitis DDX}} | |||
== | ==Evaluation== | ||
*IFA | ===Work-up=== | ||
*Indirect fluorescence assay (IFA) or ELISA testing | |||
===Diagnosis=== | |||
*Generally clinical diagnosis | |||
==Management== | ==Management== | ||
*Immunocompetent | *Immunocompetent | ||
**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 | **Child (<45kg): [[Azithromycin]] 10mg/kg x1, then 5mg/kg per day x 4 days | ||
==Disposition== | ==Disposition== | ||
*Admit if immunocompromised or evidence of systemic disease. | |||
*Otherwise discharge with PCP follow-up. | |||
* | |||
==See Also== | ==See Also== | ||
*[[Bartonella henselae]] | |||
*[[Mammalian bites]] | |||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:ID]] | [[Category:ID]] | ||
Latest revision as of 18:09, 21 February 2021
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
Disposition
- Admit if immunocompromised or evidence of systemic disease.
- Otherwise discharge with PCP follow-up.