Cat-Scratch Disease

Abstract

CAT-SCRATCH FEVER has become a newly recognized clinical entity, separable from other regional adenopathies by means of a specific skin test. This entity has also been termed nonbacterial regional lymphadenitis1 and, more recently, benign inoculation lymphoreticulosis.2 It was first reported in this country by Greer and Keefer 3 and since then, many hundreds of cases have been recorded (references 4-6 among others). These reports have outlined well the usual clinical course and some have even associated chronic lymphadenitis with cat-scratch syndrome.1,5,7 Rarely a lymph node may remain enlarged for one to two years.4,5The case presented below is that of a recurrence over two years after the initial lesion. Report of a CaseBD, a 13-year-old white female, presented herself on Dec 5, 1961, with the chief complaint of a tender swelling in the right femoral triangle, of one month's duration. She was accompanied by her 17-year-old sister, (RD), who gave a similar complaint involving the left inguinal area. Neither patient had had any systemic :ompIaints or fever during their illnesses. Each had received a course of tetracycline and BD had also received a sulfonamide in spite of which the bubos :ontinued to increase in size. Abnormal physical findings in both patients were limited to the areas of local lymphadenopathy, where tX4 cm, firm, slightly tender, swellings were palpated. These nodes were fixed to the overlying skin which ¡vas slightly red.A complete blood count was normal. Urinalysis was lormal. Tuberculin tests were negative. Both patients reacted to an intradermal injection of a properly jrepared and standardized cat-scratch antigen; BD îad a 1X1 cm area of induration surrounded by 5X4 cm area of erythema, and RD had a 0.6X0.6 cm irea of induration surrounded by 3X3 cm area of erythema. One week later, a vaccinia-type reaction

A Man in His Forties with Recurrent Cat-Scratch Disease

“…The recurrence of cat-scratch disease has rarely been reported. To the best of our knowledge, there are few case reports and a case series of CSD lymphadenitis recurrence in previously healthy patients [ 10 , 11 ]. CSD relapse in immunocompromised patients has been reported in a kidney recipient patient [ 12 ].…”

“…The patient presented with suppurative inguinal lymphadenitis two years after the initial diagnosis and had no history of cat scratches or bites. The authors concluded that it probably resulted from a flare-up of the prior infection, but they did not rule out the possibility of reinfection [ 11 ].…”