Cat-scratch disease

Background

  • Caused by Bartonella henselae

Clinical Features

  • History of cat (normally kitten) exposure
  • Lymphadenitis proximal to exposure

Parinaud's oculoglandular syndrome

  • Due to direct inoculation of the eye
  • Causes conjunctivitis, ocular granuloma, periauricular adenopathy

Differential Diagnosis

Evaluation

Work-up

  • Indirect fluorescence assay (IFA) or ELISA testing

Evaluation

  • 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.

See Also

References