Overview
Cat-bite fever, also known as cat-scratch disease (CSD), is a bacterial infection typically caused by Bartonella henselae transmitted through the scratch or bite of an infected cat. It can manifest with localized lymphadenopathy and systemic symptoms depending on the host's immune status 1.Diagnosis
Clinical History: History of cat scratch or bite is crucial 1.
Physical Examination: Look for characteristic lymphadenopathy, often regional to the site of injury 1.
Laboratory Tests: Serological tests (e.g., indirect fluorescent antibody test) can be used but have limitations in sensitivity and specificity 1.
Imaging: Rarely needed but may be considered for complications like abscesses 1.
Culture and PCR: Definitive diagnosis through Bartonella culture or PCR from blood, lymph node aspirates, or other clinical samples 1.Management
Antibiotics: Azithromycin or doxycycline are first-line treatments for immunocompetent adults 1.
Duration: Typically 14-21 days of antibiotic therapy 1.
Supportive Care: Pain management and monitoring for complications such as abscesses or sepsis 1.
Immunocompromised Patients: May require longer courses or different antibiotic choices based on specific immune status 1.Special Populations
Elderly: No specific guidelines provided; management similar to immunocompetent adults but with closer monitoring for complications 1.
Comorbidities: Management may need adjustment based on underlying conditions, particularly in immunocompromised states 1.Key Recommendations
Obtain a detailed history including potential cat exposure during physical examination and history taking 1 (Evidence: Expert opinion).
Consider serological testing for Bartonella, but interpret results cautiously due to variability in test performance 1 (Evidence: Moderate).
Initiate antibiotic therapy with azithromycin or doxycycline for 14-21 days in immunocompetent adults 1 (Evidence: Expert opinion).References
1 Ray M, Carney HC, Boynton B, Quimby J, Robertson S, St Denis K et al.. 2021 AAFP Feline Senior Care Guidelines. Journal of feline medicine and surgery 2021. link