Cat Scratch Disease: The Story Continues

Abstract

OBJECTIVE: To present a perspective on the current state of knowledge of cat scratch disease (CSD), including the evidence forBartonella henselaeas the etiological agent, epidemiological and clinical characteristics of the disease, available diagnostic tests and current therapeutic options.DATA SOURCES: MEDLINE search of the literature published from 1966 to 1995 using ‘cat scratch disease’, ‘Bartonella henselae’, ‘Rochalimaea henselae’ as key words and bibliographies of selected papers.DATA EXTRACTION: Selected studies reporting data on etiology, epidemiology, clinical characteristics, diagnosis and therapy of CSD were evaluated.DATA SYNTHESIS AND CONCLUSIONS: Evidence accumulated to date supportsB henselaeas the etiological agent of CSD. The most significant risk factors for CSD are being licked on the face, scratched or bitten by a kitten and owning a kitten with fleas. Available serological tests can confirm classic CSD and identifyB henselaeas the cause of more atypical presentations, such as fever of unknown origin, granulomatous hepatitis, encephalitis and osteomyelitis. Symptomatic management is appropriate for isolated lymphadenopathy caused by CSD in healthy individuals; however, antibiotic therapy may be indicated for patients with more severe manifestations of the disease and immunocompromised hosts. Further study of CSD, in particular the epidemiology and therapy, is warranted. A better understanding of the pathogenesis ofB henselaeinfection will have important implications in both immunocompetent and immunocompromised individuals.