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Cat-scratch disease - External and Internal Eye
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Cat-scratch disease - External and Internal Eye

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Contributors: Brandon D. Ayres MD, Christopher Rapuano MD, Harvey A. Brown MD, Sunir J. Garg MD, Lauren Patty Daskivich MD, MSHS
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Synopsis

Cat-scratch disease is a benign and self-limited bacterial infection of Bartonella henselae. It is characterized in most cases by a primary papulopustular skin lesion and enlarged localized lymph nodes, with a history of cat contact proximal to the involved node. Fatigue, malaise, pharyngitis, conjunctivitis, headache, and low-grade fever may be present. Following inoculation, incubation periods are generally a few days to several weeks.

Dermatologic involvement is seen in approximately two thirds of patients and includes evidence of a scratch without or with a papulopustular lesion, a widespread morbilliform eruption, erythema nodosum (warm, erythematous, and painful nodules in lower extremities), erythema multiforme, and/or thrombocytopenic purpura. Splenomegaly, weight loss, and parotid swelling rarely appear.

The eye is involved in less than 10% of cases. Usually only one eye is involved with either granulomatous conjunctivitis ("pink eye"), eyelid lesions (bacillary angiomatosis), or neuroretinitis. Parinaud oculoglandular syndrome is the most common ocular manifestation, with preauricular lymph node swelling on the side of the affected eye and granulomatous conjunctivitis.

In two thirds of patients, the lesion lasts for less than a month, although it may persist for 2 months or more in some cases. Nodes are tender, gradually increase in size, become erythematous and fluctuant, and may become suppurative. Most patients recover without sequelae. Encephalitis may occur in 1–7% of cases, typically appearing 2–6 weeks after classic cat-scratch disease. Patients may present with associated seizures or status epilepticus.

Codes

ICD10CM:
A28.1 – Cat-scratch disease

SNOMEDCT:
79974007 – Cat scratch disease

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Differential Diagnosis & Pitfalls

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Therapy

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Last Updated: 10/07/2015
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Cat-scratch disease - External and Internal Eye
See also in: Overview
Print 9 Images
View all Images (9)
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Cat-scratch disease : Blurred vision, Lymphadenopathy, Pustule, Arthralgia, Conjunctival injection, Myalgia, Splenomegaly, CRP elevated, ESR elevated, Chemosis, Cat exposure
Clinical image of Cat-scratch disease
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