cat-scratch disease - occurs as a result of scratches or bites cats infectious disease characterized by the wide variability of clinical manifestations, moderate general intoxication and the development of regional lymphadenitis.In some cases, there may be damage to the nervous system
cat-scratch disease - causes of
cat-scratch disease is most often exposed to cat owners.The causative agent of the disease is Bartonella small rods.For infection sometimes quite a small cat scratch or bite of a minor.In exceptional cases, infection occurs through the conjunctiva eyes.According to statistics, about forty percent of cats in certain periods of his life are carriers of Bartonella.Introduction of bacteria in the body occurs across the cat flea bites that have previously been infected by other animals.
cat-scratch disease most prone to small children and persons up to twenty years, with peak incidence usually occurs in the autumn and winter.Sometimes a fixed family outbreaks,
Risk factors for cat scratch disease: domestic cats, HIV infection, various violations of cellular immune responses, long-term use of glucocorticoids.It was noted that the owners of small kittens under the age of one year, are at much higher risk (up to 15 times!) Of developing the disease compared to the owners of adult cats
cat-scratch disease - symptoms
penetrating through the damaged cat's teeth or nails skin, an infectious agent causes inflammation at the site of penetration.Then, it reaches the lymphatic system of the adjacent lymph nodes, causing inflammation in it.After that Bartonella enters the bloodstream and spreads the blood flow throughout the body.
incubation period of the disease cat scratch lasts from three to twenty days.Typically, the disease begins gradually.At the site has had time to heal the bite or cat scratch appears nezudyaschee slightly painful elated small speck with a red rim, which in two or three days turns into a vial filled with muddy contents.Two weeks later, usually develops regional lymphadenitis, in most cases display enlarged lymph nodes of head and neck (rare inguinal, axillary and femoral).Eighty percent of cases increases only one node.Depending on its location may experience pain in the groin, axilla, the throat.About 30% of patients complain of headaches and fever.Fever is accompanied by signs of intoxication such as headache, fatigue, anorexia and so on. This condition can last for two to three months, and often spontaneously goes.
Most often affects the cervical, axillary lymph nodes, and elbow.In 5% of patients have a generalized lymphadenopathy.Enlarged lymph nodes are usually reach a diameter of 3-5 cm, but sometimes may increase and 8-10 cm. At palpation nodes are painful, with surrounding tissues are not soldered.In more than 50% of the patients lymph node abscess, many patients with cat-scratch disease is marked enlargement of the spleen and liver (duration of about two weeks).5% of patients developing Intermittent own after a week or two rash.
in 5% of patients have ocular form of cat scratch disease, which by their symptoms resemble conjunctivitis Parinaud (okuloglandulyarny Parinaud's syndrome) and developed as a result of contact with the saliva of infected cats in the conjunctiva.Most often affects one eye, while the swollen conjunctiva sharply hyperemic, it appears on a few nodules (less one) capable of ulceration.Located directly in front of the ear lobe lymph node significantly increased (up to more than 5 cm.) And often abscesses.Lymphadenopathy can last from three to four months.After the process of suppuration followed by formation of fistulas remain on the skin scarring.In some cases there is an increase not only of the parotid, the submandibular and lymph nodes.In this case, the disease is characterized by symptoms of intoxication and pronounced fever.Inflammation of the conjunctiva can last one to two weeks, and she glazoglandulyarnaya disease koshechih scratches lasts from one to twenty-eight weeks.
in 2% of patients with marked changes in the nervous system are manifested in the form of sciatica, myelitis, polyneuritis, meningitis and encephalopathy.All the neurological symptoms is accompanied by high fever.Symptoms of nervous system manifested through one - six weeks after the onset of lymphadenopathy.During the neurological studies reveal focal and diffuse changes.Sometimes there may be momentary disturbance of consciousness, there were cases coma.As complications of cat scratch disease can occur: myocarditis, splenic abscess, primary atypical pneumonia, thrombocytopenic purpura
diagnosis of cat scratch disease
Diagnostics classic form of the disease is no more difficult.The main importance is the availability of direct contact with the cat, the presence of primary affect, the development of regional lymphadenitis, in the absence of reaction of other lymph nodes.To confirm the diagnosis of blood tests carried out microbiological, histological study of biopsy of a lymph node or papules with staining sections.
Differential diagnosis is carried out with the following diseases: progressive focal leukoencephalopathy, cryptococcal meningitis, toxoplasmosis of the brain, acute hepatitis, infectious mononucleosis, influenza, histoplasmosis, coccidioidomycosis, cryptococcosis, a cancer of lymph nodes, lymphoma, streptococcal and staphylococcal infections, borrelioses, babeshioz, rickettsiosis, mycobacterioses, erysipeloid, tularemia, pasteurellosis, bubonic plague, sporotrichosis
cat-scratch disease - treatment
Treatment of cat-scratch disease complicates the lack of exposure to Bartonella medications.Consequently, the method of treatment of the disease is reduced to receive immunoukreplyayuschih and antimicrobials.Taking antibiotics is undesirable, even though that gentamicin in the treatment of cat scratch disease showed itself quite effectively.In the normal state of the immune defense, spontaneous recovery occurs over one or two months.Repeated risk of developing this disease is reduced to zero, since the body produces to Bartonella very strong immunity.
In order to prevent the disease, bites and scratches immediately cats must be treated with 2% p-rum hydrogen peroxide, followed by alcohol, iodine or brilliant green.