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Bartonellosis (Cat-scratch Disease)

By: Dr. Arnold Plotnick

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Cat-scratch Disease (CSD), also known as Rochalimaea henselae or Bartonella henselae, is an infection in humans that most often occurs after prolonged contact with a young cat. When diagnosed in cats this disease is called feline bartonellosis. It is caused by a bacteria called Bartonella henselae.

All ages, breeds, and sexes of cat are susceptible; however, kittens under one year of age, kittens or cats infested with fleas, and feral cats or former strays are more likely to have the bacteria in their bloodstream. Fleas are believed to play a major role in cat-to-cat and possibly cat-to-human transmission. Cats can be infected with the organism for months, or even years, and never show any clinical signs.

Children and immunocompromised people may suffer severe disease when infected by these bacteria. Cats are considered the major reservoir for these bacteria, although fleas and some other mammals have also been shown to play a role in the disease transmission.

What to Watch For in Cats

Bartonella is not known to cause serious disease in most cats. Most cats will have no clinical signs of illness. Some cats may exhibit:

  • Lethargy
  • Fever
  • Lack of appetite (anorexia)
  • Reproductive difficulty
  • Lymphnode enlargement
  • Vomiting
  • Red eyes (uveitis)

    What to Watch for in Humans

    Signs of human disease include raised skin lesions that are red to purple in color. Anywhere from a few to over 100 may be found on the face, trunk, arms and legs. If cat scratch disease spreads internally, it can cause fever, weight loss and vomiting. Upon examination, the liver and spleen may be enlarged. Humans with immunodeficiency problems are at higher risk for disease.

    Diagnosis

    In people, definitive diagnosis generally requires a biopsy for microscopic examination and culture.

    Other tests to diagnose the organism in cats might include:

  • Blood culture
  • Serology
  • Polymerase chain reaction (PCR)
  • Complete blood count (CBC)
  • Serum biochemical profile
  • Urinalysis
  • Feline leukemia virus testing (FeLV)
  • Feline Immunodeficiency Virus Testing (FIV)

    Treatment

    Cats with no clinical signs of disease do not require treatment. Cats that have clinical signs of disease may be treated with antibiotics and supportive care as needed. There is not a lot of information about treating this disease in cats and much of the information about treatment is extrapolated from studies in human medicine.

    In people, cat scratch disease responds to several different oral antibiotics, such as erythromycin, clarithromycin, azithromycin and doxycycline. Antibiotics are usually given for 2 to 3 months unless there is bloodstream or internal organ involvement. In advanced HIV (AIDS) disease, long-term management with lower doses is usually necessary to prevent relapse.

    Home Care and Prevention

    There is no home care for bartonellosis. Preventive care is based on maintaining good hygiene. Wash your hands after handling pets and wash scratches or bites thoroughly. Never let a cat lick an open wound, and maintain meticulous flea control. Preventative flea and tick control is recommended. For more information read , flea and tick control programs

    Blood cultures and serology should be performed on pets belonging to immunocompromised people.

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