Cat Scratch Disease (cont.)
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Cat Scratch Disease Symptoms and Signs
The first symptoms of CSD start about three to 14 days after getting scratched, superficially bitten, or (infrequently) licked by a cat, usually a kitten. These symptoms consist of one or more papules (small raised areas on the skin with no fluid inside) or pustules (like papules but with pus inside) on the skin where the cat scratch, bite, or lick occurred. In most patients, these begin to disappear spontaneously over about one to three weeks. While the papules and pustules are receding, lymph nodes that drain the primary area of infection begin to swell in about 90% of patients. The nodes most frequently involved are those in the axillary (under arms), cervical (on the neck), or inguinal (in the groin) regions. These nodes are usually painful and may suppurate (spontaneously rupture and leak pus). A low-grade fever (up to about 101 F) often develops. These are the most common symptoms of CSD; a few patients develop other localized symptoms such as a reddish, painful eye with mild fever and swollen lymph nodes near the ear and neck on the affected side (termed Parinaud oculoglandular disease). Often patients with eye involvement report being licked by a pet kitten on or near the involved eye. Pictures of CSD are available on the first reference listed below.
One note of caution: A bite from a cat (usually an adult cat) can result in another rapidly progressing infection from Pasteurella multoceda bacteria (and other organisms) and should be treated within about 48 hours of the bite. The symptoms of pain and swelling at the bite site develop rapidly (over about eight to 24 hours) in contrast to CSD symptoms. Since about 80% of cat bites become infected, the majority of people with cat bites need to be treated with antibiotics.
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