Cat scratch disease

Cat scratch disease: description

The cat scratch fever is an infectious disease caused by bacteria of the genus Bartonella. The domestic cat is the transmitter of the pathogen. She herself does not get sick or shows only minor symptoms.

The name of the disease goes back to the French doctor Robert Debré, who found in the patients scratching injuries caused by their domestic cats. The cat scratch disease is rare but widespread worldwide and occurs frequently in autumn and winter.

Cat scratch disease: symptoms

After a person has become infected with the virus, the first symptoms appear after two to ten days.

At the skin site, where the bacterium has entered the body, initially small red-brown nodules develop, which can easily be confused with an allergic reaction. The nodules do not itch and hurt and disappear after a few days or weeks.

The bacteria in the human body first attack the lymph nodes near the skin injury. These swell up and can hurt. Finally, the lymph nodes on the neck or in the armpit enlarge. In addition, the following symptoms may occur:

• Fever (mostly mild) and chills
• fatigue
• Limb, abdominal, head and sore throat
• anorexia
• recurring nausea and vomiting

Sometimes lymph node swelling occurs throughout the body during cat scratch disease. The liver and spleen also swell occasionally, causing an unpleasant pressure sensation in the upper abdomen. Particularly painful is a conjunctivitis caused by the bacteria on the eye. The nervous system can also be affected by the pathogen. Meningitis, inflammation of the eye nerves or the spinal cord are the result.

It is also possible that sufferers except the lymph node swelling have no complaints. While the symptoms such as fever, feeling sick or nausea pass quite soon, the lymph node swelling sometimes lasting for months and can also be a cosmetic problem. However, they are not dangerous.

Cat scratch disease: causes and risk factors

Cat scratch disease can affect anyone. Due to the transmission route, however, cat owners are particularly vulnerable. Since young animals are contagious, the cat scratch disease frequently occurs in households with very young cats. But even older animals can transmit the disease – 10 to 13 percent of all cats in Germany should be infected.

Most people who get cat scratch disease are younger than 21 years or children. The reason: Children often have intimate contact with pets, but on the other hand, no fully developed immune system. Adult people with immunodeficiency also often become ill with cat scratch disease, sometimes showing a more severe course.

Transmission of the bacteria

The causative agent of the cat disease reaches the claws of the cat mainly via three ways:

• When the animal licks its paws, the bacteria in its saliva and blood reach the claws.
• If a flea settles in the fur of the cat and sucks its blood, the pathogens get into the insect. With the feces of the flea, they are excreted again and are then in the coat of the cat. The injection site itches, which is why the cat is scratching. The flea feces get under their claws.
• If the cat licks a previously scratched or otherwise damaged skin area of ​​the human, the pathogen can also be transmitted.

Since the cat flea also bites people, a direct transmission of the pathogen is also possible, but far less common. However, human-to-human transmission of Bartonella bacteria has not yet been observed.

Cat scratch disease: examinations and diagnosis

The symptoms of cat scratch disease are often very different and can also occur in other diseases. Therefore, it is important for the doctor to know how the disease has developed and whether cats are in the household.

Furthermore, the blood must be examined by taking a blood sample. The body has contact with the cause of cat scratch disease, it forms specific antibodies against the bacterium, which can be detected in the blood. Special procedures can detect the pathogen very quickly in blood or tissue samples.

One can also try to “breed” the pathogen by means of a blood test. However, this takes a few weeks to get a clear result. Sometimes you have to take tissue from a swollen lymph node to diagnose the disease safely.

Cat scratch disease: treatment

The cat scratch disease heals in most cases on its own, so that a special treatment is not necessary. For symptoms such as fever and pain, analgesics such as ibuprofen or acetaminophen can help. Cooling pads relieve the pain in swollen lymph nodes.

Sometimes the cat scratch disease lasts longer or the symptoms are very pronounced. Then antibiotics can be used and shorten the course of the disease.

Cat scratch disease: Disease course and prognosis

In most cases, the cat scratch disease is harmless. Rarely, however, complications can occur if, for example, the bacteria infect the bones, the heart or the lungs and cause inflammation there.

Because the Bartonella bacteria also attack the red blood cells, they sometimes die. If the pathogens multiply in the blood too much, this can lead to blood poisoning (sepsis) and anemia (anemia). Blood poisoning is life threatening and must be treated in an intensive care unit.

The cat scratch disease in immunodeficiency

People with immunodeficiency are at an increased risk of contracting cat scratch disease. The disease can also be severe or lead to rare symptoms in this case.

Bacillary angiomatosis

For example, if the immune system is weakened as a result of HIV infection, the bacterium Bartonella can trigger so-called bacillary angiomatosis. The pathogen multiplies in the smallest blood vessels in the skin and on the organs such as the liver, spleen and eye, as well as the lymph nodes and the nervous system.

The tiny blood vessels start to grow and appear in the skin as small dark red to purple nodules. They occur individually or in groups and are partially distributed over the entire body. In the process, the nodules can break, bleed and inflame. The liver may develop small blood-filled cavities (cysts).

Preventive measures

As the most important preventative measure, fleas in domestic cats should be combated radically. After contact with the cat it is advisable to wash one’s hands. People with immunodeficiency should prove to be the most important preventive measure against the Cat scratch disease Keep away from cats.