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Cat Scratch Disease (CSD or Cat Scratch Fever)

Cat Scratch Disease Overview

Cat scratch disease (CSD) is a syndrome that begins usually with red, tender papules or pustules at a site where a pet cat (usually a kitten) has scratched, licked, or superficially bitten a person that later progresses to (in about one to three weeks) painful regional lymph nodes. Up to 60% of affected patients develop a low-grade fever (about 101 F). A few investigators suggest fleas on cats may also transmit the disease under special circumstances (for example, crushed cat flea materials get into a skin break).

Although H. Parinaud described this condition in 1889, R. Debre in 1931 was the first to describe cats as vectors (carriers) of the disease and termed the condition as cat scratch disease. About 70%-90% of cases occur in the fall and winter months; investigators speculate this timing may be due to the usual high number of midsummer kitten births. The bacteria responsible for the disease are Bartonella henselae; recently, two other organisms (Afipia felis and Bartonella clarridgeiea) have also been implicated in producing CSD, but investigators are still gathering data to prove this. CSD is not transmitted from person to person.

The U.S. Centers for Disease Control and Prevention (CDC) has reported that about 22,000 cases of CSD occur each year but suggested this number may be a very low estimate, since many cases are not reported because the symptoms are often mild and the disease is self-limiting. Population studies suggest a wide range of the total U.S. population (from about 3%-60%) are seropositive (have antibodies in their blood) for Bartonella henselae, suggesting a previous infection. This is not surprising to many investigators since the pet cat population in the U.S. is estimated to be about 60 million. The majority of people who get CSD are under 21 years old.

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