[Cat scratch disease]

Cat scratch disease (CSD) is usually manifested in children and young adults as a benign, chronic self-limited lymphadenopathy. However, various atypical presentations have been described, especially in immunocompromised hosts. 1 of 5 cases of CSD diagnosed here during 1985-1993 is presented. In 3 cases the diagnosis was supported by lymph node biopsy in which the organisms were visualized by Warthin-Starry silver impregnation staining. Recent publications indicate that Afipia felis and Rochalimaea henselae, both Gram-negative bacilli, were isolated from infected lymph nodes in CSD. The usual benign course does not necessitate antibiotic therapy. The antimicrobial agents effective in cases with systemic symptoms were rifampicin, ciprofloxacin, trimethoprim-sulfamethoxazole and gentamicin. In view of the increasing number of cats, an increased incidence of CSD may be expected. The mechanism of transmission from cat to man is still unknown. Fleas or ticks may be involved. Hopefully, recent advances in the identification of the causative organisms may lead to the development of serological tests, reducing the need for skin testing and lymph node biopsy.