Name of the Condition

• Common Names: Cat-scratch disease (CSD)
• Medical Term: Bartonella henselae infection

Summary

Cat-scratch disease is an infection resulting from a scratch or bite by a cat, most commonly caused by the bacterium Bartonella henselae. It often leads to swollen lymph nodes and may resolve on its own or require medical attention, depending on severity.

Causes

• Cat-scratch disease is primarily caused by the bacterium Bartonella henselae.
• Transmission occurs through bites or scratches from infected cats, and less commonly through flea bites.

Risk Factors

• Owning or handling kittens or stray cats.
• Living in areas with high cat populations.
• Individuals with a weakened immune system are more at risk for severe forms of the disease.

Symptoms

• Swollen and tender lymph nodes near the site of the scratch or bite.
• Fever, fatigue, and headaches.
• Occasionally, red bumps (papules) at the infection site.
• In some cases, complications such as eye infections or severe infections may occur.

Diagnosis

• Physical examination focusing on symptoms and history of cat exposure.
• Serological tests to detect Bartonella henselae antibodies.
• Biopsy of the affected lymph node in uncertain cases.

Treatment Options

• Most cases resolve without treatment, focusing on symptom management with analgesics and antipyretics.
• Antibiotics such as azithromycin may be prescribed in severe cases or immunocompromised patients.
• Lymph node aspiration might be required for painful, swollen lymph nodes.

Prognosis and Follow-Up

• Prognosis is excellent; most individuals recover fully without significant medical intervention.
• Follow-up often involves monitoring symptoms in severe cases or if treatment is not effective.

Complications

• Parinaud’s oculoglandular syndrome (conjunctivitis and swollen lymph nodes near the eye).
• Neurological complications, though rare, can involve encephalitis or neuroretinitis.
• Osteomyelitis and endocarditis in individuals with weakened immune systems.

Lifestyle & Prevention

• Avoid rough play with cats or kittens to reduce risk of scratches and bites.
• Ensure regular flea control on cats.
• Wash cat bites and scratches immediately and thoroughly with soap and water.

When to Seek Professional Help

• If symptoms such as persistent swollen lymph nodes or fever develop following a cat scratch or bite.
• Immediate medical attention if experiencing severe symptoms or if there is a weakened immune system.

Additional Resources

• Centers for Disease Control and Prevention (CDC) - Cat-Scratch Disease Information
• American Academy of Pediatrics - guidance on cat-related illnesses.

Tips for Medical Coders

• Use ICD code A28.1 specifically for cat-scratch disease.
• Ensure accurate documentation of the bacterial cause (Bartonella henselae) if provided.
• Verify the absence of complications to avoid additional coding errors.