CAT-SCRATCH DISEASE (CSD)
MICROBIOLOGY AND EPIDEMIOLOGY: -
- henselae is the principal etiologic agent of CSD, although other Bartonella species may rarely be involved. Consistent with the disease’s name, contact (being scratched, bitten, or licked) with apparently healthy cats, and especially with kittens, is the primary source of infection. Adults are affected nearly as frequently as children. In the U.S., the estimated incidence is ~10 cases per 100,000 populations.
CLINICAL MANIFESTATIONS: -
Of pts with CSD, 85–90% have typical disease consisting of a localized lesion (papule, vesicle, or nodule) at the site of inoculation with subsequent painful regional lymphadenopathy ≥1–3 weeks after cat contact.
- Axillary and epitrochlear nodes are most commonly involved and suppurate in 10–15% of cases.
- Low-grade fever, malaise, and anorexia develop in ~50% of pts.
- Atypical disease involves extranodal manifestations (e.g., fever of unknown origin, ophthalmologic manifestations, neurologic involvement, osteomyelitis).
- In immunocompetent pts, the disease resolves spontaneously without treatment, although its resolution takes weeks or months.
Serologic testing is most commonly used but is variably sensitive and specific. It is noteworthy that seroconversion may take a few weeks. Bartonella species are difficult to culture, but PCR analysis of lymph node tissue, pus, or the primary inoculation lesion is highly sensitive and specific.
HOMEOPATHIC MANAGEMENT: -
The medicines that can be thought of use are:-
- Ledum palustre
- Arsenic album