Cat scratch disease
Mark McGraw BSN, RN, CCRN, CEN, CTRN

$7.95 		Nursing2013
February 2013 
Volume 43  Number 2
Pages 50 - 54
 
  PDF Version Available!

ABSTRACT
EIGHT-YEAR-OLD HD presents to triage with her mother, who reports that HD has been "sick" for the past 2 weeks. She was seen by her pediatrician the previous week after she was scratched by a feral cat. HD was given cephalexin. HD's mother reports increased listlessness, fever, and enlarged, tender axillary masses that have gradually increased in size over the past 3 days. HD begins to cry and says she wants to go home and check on "Molly and her babies." HD's mother says Molly is one of several stray cats that have been living in a wooded area behind their house.HD's mother says she had similar signs and symptoms a few weeks earlier but they spontaneously resolved without medical intervention. After an extensive workup to rule out malignancy and life-threatening infections, HD is diagnosed with cat scratch disease, also known as cat scratch fever.Cat scratch disease (CSD) is caused by infection with the Bartonella henselae bacterium. B. henselae is a Gram-negative, slow-growing, aerobic bacillus that invades humans when cat saliva that contains the bacteria comes in contact with broken skin. Cats shed the bacteria through their saliva and leave live bacteria on their claws as they clean themselves. B. henselae causes infection similar to other arthropod-borne illnesses such as Lyme disease.1B. henselae is a benign condition in cats, and the infected animal doesn't display any signs of illness. Cats don't spread the infection to other cats by biting or scratching; it's spread from cat to cat by the cat flea, Ctenocephalides felis. Humans can't transmit CSD to other humans regardless of contact.2Felis domesticus, or the common house cat, is the primary reservoir for B. henselae as well as the primary vector responsible for transmission of CSD disease to humans.2 But despite the name "cat scratch," it's important to understand that felines aren't the only reservoir for this disease, nor are they the only species that can transmit the infection to humans. Canines, coyotes,

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