Cat Scratch Disease: Red Papules, Diagnosis, Treatment and Case Analysis
Cat Scratch Disease: Red Papules, Diagnosis, Treatment and Case Analysis
Cat scratch disease (CSD), also known as cat scratch fever, is an infectious disease caused by Bartonella henselae, a bacterium commonly transmitted through cat scratches or bites. While CSD is usually benign and self-limiting, it can lead to serious complications, such as swollen lymph nodes, red papules, fever, and systemic illness. Therefore, timely identification and treatment of CSD are crucial.
Symptoms and Signs of Cat Scratch Disease
The most common symptoms of CSD include:
Red papules: Red papules appear near the site of the cat scratch or bite, often red or purple in color, with a possible central pustule.
Swollen lymph nodes: Lymph nodes near the site of the cat scratch or bite swell, usually accompanied by pain and tenderness.
Fever: Fever typically occurs within a few weeks after the onset of red papules and swollen lymph nodes.
Other symptoms: Other symptoms may include headache, fatigue, decreased appetite, joint pain, and muscle aches.
Diagnosis of Cat Scratch Disease
The diagnosis of CSD is typically based on clinical symptoms and history, as well as the following tests:
Pathological examination: A biopsy of the swollen lymph nodes is performed to examine tissue cell reactive hyperplasia and granuloma formation, and the presence of Bartonella henselae.
Serological tests: Detection of antibodies to Bartonella henselae in serum.
Treatment of Cat Scratch Disease
Most patients with CSD do not require treatment because the disease resolves on its own. However, for patients experiencing severe symptoms or complications, the following treatments may be necessary:
Antibiotics: Such as doxycycline, azithromycin, and clindamycin, can help control the infection and reduce symptoms.
Pain relievers: Can help alleviate pain caused by swollen lymph nodes.
Anti-inflammatory medications: Can help reduce inflammation and swelling.
Prevention of Cat Scratch Disease
To prevent CSD, consider the following precautions:
Avoid contact with infected cats: If your cat shows signs of scratches or bites, take it to a veterinarian for examination.
Maintain good hygiene for your cat: Bathe your cat regularly and clean its claws regularly.
Prevent cats from contacting your wounds: If you have a wound on your skin, avoid letting your cat contact it.
Vaccination: Currently, there is no effective vaccine for CSD.
Case Analysis: A Cat Scratch Disease Case of a Patient with a Rabbit Bite
Patient information: Female, 53 years old.
History: The patient was bitten by a rabbit on her left index finger in early 2020. The skin was still red and swollen at the time of the visit.
Clinical symptoms: Cough and phlegm production for more than 10 days, no hemoptysis or fever.
Test results: CT showed multiple enlarged lymph nodes in the neck root, mediastinum, and bilateral hilar regions, suggesting malignancy; previous scar tissue formation in the right 9-10 ribs; bone destruction in the cervical spine, left clavicular acromion, and right scapula. ECT showed widespread bone metastases. Pathology (7 groups of lymph nodes, fine-needle aspiration biopsy) showed no significant tumor cells and no significant positive bacteria. PET/CT showed multiple hypermetabolic nodules in many parts of the body, including the left tongue root, bilateral neck, bilateral clavicle, bilateral axilla, right internal mammary artery, bilateral hilar, mediastinum, bilateral intermuscular spaces of the chest wall, left elbow trochlea, retroperitoneum, pelvis, and bilateral inguinal region. Multiple vertebral bodies and their appendages, hyoid bone, sternum, bilateral clavicle, bilateral scapula, bilateral humerus, multiple ribs on both sides, left proximal femur, and pelvis showed mixed bone density, blurred margins, and varying degrees of metabolic increase.
Pathological diagnosis: The lymph node (left neck mass) showed disappearance of the normal structure, massive infiltration of lymph nodes and neutrophils, formation of microabscesses, reactive hyperplasia of stromal cells, and multinucleated giant cells. Consistent with necrotizing granulomatous inflammation of the lymph node with purulent inflammation. Special staining did not reveal positive bacteria.
Bacterial culture: Staphylococcus epidermidis, Micrococcus luteus.
Diagnosis: Combining clinical symptoms, history, test results, and bacterial culture results, the diagnosis was cat scratch disease involving lymph nodes, bones, and skin.
Treatment: The patient was undergoing treatment with clindamycin, doxycycline, and methylprednisolone.
Summary
Cat scratch disease is a common condition but can be easily misdiagnosed due to its atypical symptoms. Therefore, during diagnosis, it is essential to carefully inquire about the patient's history, including pet contact history, and perform necessary tests such as pathological examination, serological tests, and PET/CT. Cat scratch disease treatment is relatively simple, and most patients do not require treatment, but timely treatment should be provided for patients with severe symptoms or complications. Preventing CSD is key to avoiding contact with infected cats, maintaining good hygiene for your cat, and preventing cats from contacting your wounds.
Cat scratch disease (CSD), also known as cat scratch fever, is an infectious disease caused by Bartonella henselae, a bacterium commonly transmitted through cat scratches or bites. While CSD is usually benign and self-limiting, it can lead to serious complications, such as swollen lymph nodes, red papules, fever, and systemic illness. Therefore, timely identification and treatment of CSD are crucial.
Symptoms and Signs of Cat Scratch Disease
The most common symptoms of CSD include:
Red papules: Red papules appear near the site of the cat scratch or bite, often red or purple in color, with a possible central pustule.
Swollen lymph nodes: Lymph nodes near the site of the cat scratch or bite swell, usually accompanied by pain and tenderness.
Fever: Fever typically occurs within a few weeks after the onset of red papules and swollen lymph nodes.
Other symptoms: Other symptoms may include headache, fatigue, decreased appetite, joint pain, and muscle aches.
Diagnosis of Cat Scratch Disease
The diagnosis of CSD is typically based on clinical symptoms and history, as well as the following tests:
Pathological examination: A biopsy of the swollen lymph nodes is performed to examine tissue cell reactive hyperplasia and granuloma formation, and the presence of Bartonella henselae.
Serological tests: Detection of antibodies to Bartonella henselae in serum.
Treatment of Cat Scratch Disease
Most patients with CSD do not require treatment because the disease resolves on its own. However, for patients experiencing severe symptoms or complications, the following treatments may be necessary:
Antibiotics: Such as doxycycline, azithromycin, and clindamycin, can help control the infection and reduce symptoms.
Pain relievers: Can help alleviate pain caused by swollen lymph nodes.
Anti-inflammatory medications: Can help reduce inflammation and swelling.
Prevention of Cat Scratch Disease
To prevent CSD, consider the following precautions:
Avoid contact with infected cats: If your cat shows signs of scratches or bites, take it to a veterinarian for examination.
Maintain good hygiene for your cat: Bathe your cat regularly and clean its claws regularly.
Prevent cats from contacting your wounds: If you have a wound on your skin, avoid letting your cat contact it.
Vaccination: Currently, there is no effective vaccine for CSD.
Case Analysis: A Cat Scratch Disease Case of a Patient with a Rabbit Bite
Patient information: Female, 53 years old.
History: The patient was bitten by a rabbit on her left index finger in early 2020. The skin was still red and swollen at the time of the visit.
Clinical symptoms: Cough and phlegm production for more than 10 days, no hemoptysis or fever.
Test results: CT showed multiple enlarged lymph nodes in the neck root, mediastinum, and bilateral hilar regions, suggesting malignancy; previous scar tissue formation in the right 9-10 ribs; bone destruction in the cervical spine, left clavicular acromion, and right scapula. ECT showed widespread bone metastases. Pathology (7 groups of lymph nodes, fine-needle aspiration biopsy) showed no significant tumor cells and no significant positive bacteria. PET/CT showed multiple hypermetabolic nodules in many parts of the body, including the left tongue root, bilateral neck, bilateral clavicle, bilateral axilla, right internal mammary artery, bilateral hilar, mediastinum, bilateral intermuscular spaces of the chest wall, left elbow trochlea, retroperitoneum, pelvis, and bilateral inguinal region. Multiple vertebral bodies and their appendages, hyoid bone, sternum, bilateral clavicle, bilateral scapula, bilateral humerus, multiple ribs on both sides, left proximal femur, and pelvis showed mixed bone density, blurred margins, and varying degrees of metabolic increase.
Pathological diagnosis: The lymph node (left neck mass) showed disappearance of the normal structure, massive infiltration of lymph nodes and neutrophils, formation of microabscesses, reactive hyperplasia of stromal cells, and multinucleated giant cells. Consistent with necrotizing granulomatous inflammation of the lymph node with purulent inflammation. Special staining did not reveal positive bacteria.
Bacterial culture: Staphylococcus epidermidis, Micrococcus luteus.
Diagnosis: Combining clinical symptoms, history, test results, and bacterial culture results, the diagnosis was cat scratch disease involving lymph nodes, bones, and skin.
Treatment: The patient was undergoing treatment with clindamycin, doxycycline, and methylprednisolone.
Summary
Cat scratch disease is a common condition but can be easily misdiagnosed due to its atypical symptoms. Therefore, during diagnosis, it is essential to carefully inquire about the patient's history, including pet contact history, and perform necessary tests such as pathological examination, serological tests, and PET/CT. Cat scratch disease treatment is relatively simple, and most patients do not require treatment, but timely treatment should be provided for patients with severe symptoms or complications. Preventing CSD is key to avoiding contact with infected cats, maintaining good hygiene for your cat, and preventing cats from contacting your wounds.
This article is original, please keep the link when forwarding:https://www.5zo.net/showinfo-3-81506-0.html