Felinosis (cat scratch disease): symptoms and treatment

Cat scratch disease (felinosis) is an infectious disease that begins to progress due to a bite or cat scratches. It flows with the formation of a specific inflamed papule, which becomes the cause of regional lymphadenitis. The consequences of this pathology can be extremely dangerous.



A person from any age category can infect, but nevertheless more often an ailment is diagnosed in young children. This is due to the fact that children like to play with cats, and also because their immune system is not yet sufficiently formed to fully counteract the infection. Treatment of the disease is recommended to be carried out under in-patient conditions under the supervision of specialists, but therapy in the home (with a light form) is also possible.

Etiology

The main reason for the progression of pathology is the introduction into the body of the mobile bacterium Bartonella. It lives and actively reproduces in the oral cavity of mammals (cats, monkeys, dogs, etc.). The very same animals are infected with fleas. Bartonella is contained in their excrement, which remains on the coat and skin of the animal. In the mouth and claws, the pathogen enters when the cat begins to lick the skin or simply itches.

Risk Factors


  • content of domestic cats
  • disturbance of cellular immune reactions
  • HIV infection
  • long-term use of certain groups of medications: azatrioprine, glucocorticoids, cyclosporine and others

Development Mechanism

The disease of cat scratch begins to progress gradually. Pathogenic microorganism penetrates deep layers of the epidermis through microtraumas of the skin (scratches, abrasions, cuts, punctures). At the site of the inflammation begins with suppuration. Infectious agents with a current of blood and lymph spread throughout the body. The inflammatory process also progresses in the lymph nodes.

General Symptoms

The incubation period of cat scratch disease is from several days to 1.5 months. The fact that the bacterium does not immediately manifest its activity after introduction into the body, significantly complicates the diagnosis of felinosis. It is difficult to relate the scratch that was obtained a month ago, with the worsening of the patient’s condition at the moment. Symptoms of the disease usually appear gradually.

After healing of a scratch, a small red tubercle appears in its place. If you press on it, you get pain. Later, he degenerates into a vesicle. Form can be as a single bubble, and several. Pathological elements on the skin do not last long. After their disappearance there is an ulcer, top covered with a crust. But on this cat scratch disease does not end.

After the disappearance of the bubbles, the symptoms of the development of the inflammatory process in the lymph nodes begin to appear:


  1. itching;
  2. the lymph node increases;
  3. increase in temperature to critical levels (as the process is infectious, possibly up to 40 degrees)
  4. when pressing on the affected lymph node, his soreness is noted.

Against the background of the development of felinosis, the general condition of the patient gradually worsens. He has long and severe headaches, drowsiness. Sometimes there is increased sweating. 10 days after the first symptoms of the pathology appeared, a remission was made. At this time, the inflammation in the node either completely passes, or you need to see a doctor in order to remove the purulent contents from it.

Forms

The cat scratch disease has two forms of development:


  • typical;
  • abnormal.

Typical

This form of felinosis is diagnosed in 90% of patients. Symptoms manifest gradually. There is a lesion of the skin and regional lymph nodes. More often there is inflammation of the lymph nodes on the neck, in the armpit, elbows, groin. The affected node can grow up to 12 cm in size. In case of felinosis, a pronounced intoxication syndrome is observed:


  1. headache;
  2. temperature increase;
  3. drowsiness;
  4. increased fatigue;
  5. Lack of appetite
  6. pain in the muscle structures of the limbs
  7. increased sweating.

Atypical form

This form of felinosis occurs in 10% of cases. Usually it is diagnosed in children, as well as the elderly (people whose reactivity is reduced). Duration of the disease is from 6 to 8 weeks.

If there are infectious agents on the mucous eyes, there is a high risk of developing conjunctivitis. Symptoms in contact with skin:


  • fever;
  • occurrence of ulcers
  • suppuration of lesions;
  • Scars form after healing.

Complications

If the appearance of the first symptoms of felinosis does not appeal to a doctor and do not complete treatment of the pathology, then the development of dangerous complications. In the case of progression of conjunctivitis, loss of vision is possible. It is not excluded the defeat of the central nervous system. This leads to a progression of meningitis, inflammation of the brain and spinal cord.




Diagnostics

Diagnosis of felinosis includes:


  1. personal examination by a dermatologist
  2. anamnesis collection (it is especially specified whether there were contacts with pets, in particular, with cats)
  3. a skin test with a specific Ar;
  4. histological examination of lymph node material taken by biopsy

Differential Diagnosis:


  • bubonic plague
  • sporotrichosis
  • Tularemia
  • lymphoma;
  • borreliosis;
  • babesiosis
  • Erisipeloid
  • Cryptococcosis
  • Staphylococcal and streptococcal infections
  • Histoplasmosis.

Treatment

Treatment of pathology should be done only after the diagnosis was confirmed. Therapy is prescribed by the doctor, based on the results of the tests, as well as taking into account the patient’s condition, the severity of the course of his illness. In the case of leaking felinosis in an easy form, specific treatment is usually not required, since the symptoms disappear on their own in 2 weeks. A complex form involves treatment in a hospital setting with the appointment:


  1. antibiotics
  2. vasoconstrictor drugs
  3. pain relievers
  4. the location of the lesion must be treated with disinfectant solutions




Also, doctors treat complications that could develop against the backdrop of pathology. It is possible to increase the dose of antibiotics and antimicrobials in the case of progression of meningitis or endocarditis. Treatment is considered effective if all the symptoms of the disease disappear and the patient’s general condition is stabilized.