cat scratch fever

renerian, BSN, RN · Dec 20, 2002

My dtr developed cellulitis when she was 5 from a cat scratch.

renerian

oramar · Dec 20, 2002

Nice to hear from you renerian, I have seen many nasty cases of cellulitis over the years from cat scratches. Am not satisfied with info I get from typing in searches. Thought maybe someone here would know. Now I am thinking maybe infection control would be better place.

PennyLane, RN · Dec 20, 2002

I have heard that pregnant women should under no circumstances change the cat litter, but I haven't heard anything about them not being to HAVE cats. And I thought it was taxoplasmosis that you can get? Is that the same as Cmv?? sorry, not much help, I know.

renerian, BSN, RN · Dec 20, 2002

Oramar nice to hear from you too! I did a search on a couple search engines and cannot respond to the question as to whether it is the same infection..............HEATHER where are you??????Need an OB RN? LOL.

renerian

LilgirlRN, ADN, RN · Dec 20, 2002

Hope this helps :) Wendy

Cat Scratch Disease

by Susan Little, DVM

For almost 100 years, cat scratches have been associated with illness in people. Cat Scratch Disease (CSD) is also called Cat Scratch Fever and benign lymphoreticulosis. While CSD is found all over the world, it is an uncommon disease. One estimate by the Centers for Disease Control found that there were 2.5 cases of CSD per 100,000 people per year in the United States. While multiple cases of CSD in one household can occur, this situation is rare. A study in Florida found that more than one member of a family contracted CSD only 3.5% of the time. The majority of individuals who contract CSD are under the age of 17, and are usually under the age of 12.

Typically, a small skin lesion (resembling an insect bite) develops at the site of a cat scratch or (less commonly) a bite, followed within two weeks by swollen lymph nodes and sometimes a fever. The illness is mild and self-limiting in the majority of patients, although it may take some months for the swollen lymph nodes to return to normal. Treatment is usually not required. Reports over the last few years, however, have extended the spectrum of problems associated with CSD to include such things as tonsillitis, encephalitis, hepatitis, pneumonia and other serious illnesses in a very small number of cases. People with compromised immune systems, such as AIDS and cancer patients, are most at risk and can become most seriously ill.

Diagnosis of CSD may not be easy. There is no simple diagnostic test. Most physicians rely on history of exposure to a cat , the presence of typical clinical signs, failure to find another cause, and examination of tissues, such as biopsy of a swollen lymph node. Other diseases, such as tuberculosis, brucellosis, and lymphoma, can cause similar symptoms.

Over the years, the cause of CSD had remained elusive, although bacteria were commonly suspected to be the culprit. In 1988, a bacterium called Afipia felis was cultured from the lymph nodes of patients with CSD. In recent years, many studies have implicated the gram negative bacterium Bartonella henselae as the primary (but not the sole) cause of CSD. B. henselae is related to the agent of Trench Fever, B. quintana, a disease common in the trenches of World War I. Other Bartonella species may also be involved in CSD.

Cats are the main reservoir for B. henselae. Surveys for B. henselae antibodies in cats in the United States have found average infection rates to be from 25% to 41% in clinically healthy cats. The lowest rates were in the midwest and great plains regions (4-7%) and the highest were in the southeast (60%). Warmer, more humid climates are most supportive of fleas, which have been shown to transmit B. henselae from cat to cat. It appears that the majority of cats do not become ill when they are infected with this bacterium and kittens are more commonly infected than adults. Experimental infections in cats, however, have caused a mild illness with fever, anemia, and transient neurological dysfunction. Once infected, cats carry bacteria in their blood for many months. It is important to note, however, that despite widespread presence of B. henselae in cats, CSD itself is uncommon. It appears that CSD is not easily acquired.

While most patients with CSD have a history of a cat scratch or bite, not all do. Some patients have had no contact with cats at all. This makes the exact modes of transmission unclear. It is likely that CSD can also be contracted from environmental sources of the bacteria or from other animals. For this reason, the term "bartonellosis" is a better way to describe the variety of illnesses that are caused by B. henselae. Recently, it has been found that dogs can become ill with a related Bartonella species and the role of dogs as a possible reservoir for human infection is undergoing study.

CSD is primarily a concern in homes with immunocompromised people. Since kittens are more likely to carry B. henselae than adult cats, it is recommended that people with compromised immune systems adopt cats older than 1 year of age as pets to reduce the risk of contracting CSD. Any cat suspected of carrying B. henselae should be isolated from sick or immunocompromised individuals. However, there is no reliable and available diagnostic test to determine if a cat is a carrier of B. henselae. Since carrier cats are always healthy and multiple cases of CSD within a household are rare, euthanasia of a suspected carrier is not warranted. Onychectomy (declawing) is also not recommended, since infection can occur without a cat scratch. As is always the case, any cut or scratch should be promptly washed with soap and water. In addition, children should be taught not to tease or annoy cats and rough play should be discouraged. A common sense approach is the best way to safeguard against CSD.

Further reading:

Abbott RC, Chomel BB, et al. Experimental and natural infection with Bartonella henselae in domestic cats. Comparative Immunology, Microbiology, and Infectious Disease, Vol 20(1), 1997, p. 41.

Breitschwerdt EB. Bartonellosis: of cats, dogs, mice and me. Proceedings of the 15th American College of Veterinary Internal Medicine Forum, 1997, p. 505.

Chomel BB, Kasten RW, et al. Experimental transmission of Bartonella henselae by the cat flea. Journal of Clinical Microbiology, Vol 34(8), August 1996, p. 1952.

Groves MG, Hoskins JD, Harrington KS. Cat Scratch Disease: an update. Compendium on Continuing Education for the Practicing Veterinarian Vol 15(3), March 1993, p. 441.

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oramar · Dec 20, 2002

Why thank you, that is what I wanted. No wonder I was confused. I was trying to remember CSD and the initials CMV kept popping into my head. Yes, I to was hoping Heather might post on this with more info about risk in pregnancy.

LilgirlRN, ADN, RN · Dec 20, 2002

Try looking under TORCH diseases related to pregnancy and see if you have any luck. :)

SmilingBluEyes · Dec 20, 2002

I am OB nurse, too, like Heather, (there are a few of us here)---- and a cat owner. I followed the common-sense approach and was sensible thru my pregnancies (my current kitty is 12 years old, 2 years preceding my oldest kid). I never got sick. I never changed the litter box when I was pg or trying to conceive. In over 20 years of owning cats, neither I nor any other family member has had a problem with any disease associated with cats, including CSD or Toxoplamosis. It takes common sense and hygiene, simply put. And, yes a measure of luck. (ANY animal can carry inherent risks just by its existance among humans). It also helps if the cat lives indoors where you can monitor what he/she comes into contact with and eats, and you control parasites and fleas.

oramar · Dec 21, 2002

I really appreciate the info provided thus far and am reading it with interest.

KaroSnowQueen, RN · Dec 21, 2002

I was told by my OB not to touch cat litter when I was pregnant for fear of catching several things which he rattled off and I don't recall now.

My daughter was 15 when she caught cat scratch fever from one of her numerous cats. She went to visit some of her "other" family and when she came home a week later, she had a temp, and a large knot on her neck. Tried needle aspiration and nothing. Had to have surgery to remove the knot which was a lymph node swollen and hard, pathology came back with the technical name for cat scratch fever. Had to take antibiotics post op for two weeks to make sure it was all gone.

NOT something a pregnant woman would need to go through.

My daughter had been around animals all her life, she is one of those kids that just gravitate to animals, cats, dogs, horses, fish, frogs, snakes, cows, etc. The cat who gave it to her was a house cat too.

caroladybelle, BSN, RN · Dec 21, 2002

I thought that the big worry with pregnancy and handling cats had to do with Toxoplasmosis. (And if you had already had antibodies, that there was no danger).

But then, I am Onco/Hemo, so I see few pregnant pts.