Cat scratch fever- a real medical condition

Cat Scratch Disease is a real illness, though many doctors are unfamiliar with it. Learn the symptoms and causes so you can help your doctor diagnose it properly.

By Vincent Chen, N.D.   Talk to the Author.

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Cat scratch fever- a real medical condition

Cat Scratch Fever, also known as Cat Scratch Disease and Benign Lymphoreticulosis, is considered a rare disease. The Center for Disease Control estimates that only 2.5 out of 100,000 people per year contract the disease in the United States. CSD is most often seen in children under the age of 17, with the majority of cases being found in children under the age of 12. CSD is rarely found in adults. Further research is needed to discover why this is the case, but it is commonly thought that children are more sensitive to the bacteria that cause CSD than adults.

The primary cause of Cat Scratch Disease is Bartonella henselae, bacteria found mainly in cats. An estimated 25-41% of otherwise healthy cats are afflicted with B. henselae, though the bacteria cause no symptoms in most cats. Transmission from cats to humans is fairly rare, as the reported cases of human infection are small compared to the number of cats that are infected. It is extremely rare to find more than one case of CSD in one household, in fact, it is entirely possible for one member to be infected, while other people living in the same house do not contract Cat Scratch Disease. Fleas have been shown to transmit the bacteria between cats, especially in warm climates where fleas are more prevalent, and studies are being done to see if it is possible for fleas to transmit the disease from a cat to a human. Kittens are more commonly infected than adult cats. Once infected, the bacteria remain in the cat's bloodstream for many months. There is no test to determine if a cat is currently infected with the bacteria, only that the cat has antibodies for B. henselae.

Humans acquire CSD mainly by getting scratched, and more rarely, bitten, by a cat. Because of a number of cases where the victim has had no contact with a cat, it is apparent that CSD is spread through other means, though those means are unknown at this time. Dogs have recently been discovered to have a version of the B. Henselae bacteria, and are currently being studied for further connections to human infection.

The main symptoms of CSD are swollen lymph nodes, usually on the side of the neck, and a low-grade fever, often accompanied by tiredness or listlessness. In many cases, within 3 to 10 days of the scratch or bite, the site of the injury will develop a small lesion, similar to an insect bite. Physicians who are familiar with CSD will rule out other possible causes, ask about exposure to cats, and take into account the symptoms. A blood test for CSD antibodies can be performed, as can a skin test for a positive response to the CSD antigen. CSD, once diagnosed, is normally left untreated, as it will subside on its own. The lymph nodes can remain swollen for months after exposure, though. Recently, in a small number of cases, CSD has been linked to tonsillitis, pneumonia, hepatitis, and encephalitis. More study is needed to decipher the link between CSD and other conditions.

People with compromised immune systems are most at risk for becoming seriously ill from CSD. Therefore, AIDS patients and cancer patients should be particularly careful around cats, adopting only cats that are over a year old, and exercising caution when dealing with the cat.

Children, who are most susceptible to being infected, should be taught not to tease or play roughly with cats. Any scratch or bite should immediately be washed with warm water and soap. Keep a close eye on any cat-related wounds, and if a lesion develops, followed by swelling of the lymph nodes and fever, take the victim to a physician for confirmation. Remember to tell your doctor that the victim has been in contact with a cat, since CSD isn't common enough to be a frequent diagnosis for him. The fever subsides within 4-10 days, but the lymph nodes can remain swollen for months.

Cat Scratch Disease is not in itself fatal, though it has been linked to the secondary conditions listed above. In a healthy person, these are very rare, however, in a person with an immunodeficiency, they can be severe and life threatening.

The best course of prevention is to avoid being scratched or bitten by a cat, making sure your cat is kept free of fleas, and quickly washing any scratch or bite wound with warm, soapy water. There is no need to avoid contact with cats or give away any you currently have. CSD is a rare occurrence and by using care and taking the proper precautions, you can safely share your home with a cat.

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