'A common, usually benign illness following cutaneous inoculation from a kitten scratch. Cat-scratch disease is the most common cause of chronic (>3 weeks) lymphadenopathy in children.
Epidemiology – 24,000 cases/year in USA
Incidence: Kids (5-14 y/o) > Adults.
> 90% have a history of cat (kitten) contact. Human to human transmission NOT reported.
Fleas are felt to be involved in transmission (some people get CSD with no history of scratch).
Clinical Manifestations
Round red-brown nontender papule develops in scratch line after 3-10 days, persists from few days to 2-3 weeks.
in next 1-2 weeks regional lymph nodes (upper extremity>neck and jaw>groin) enlarge gradually and become tender, warm and indurated, then resolve after ~ 1month. Patients are usually afebrile.
Entire duration of illness 2-3 months.
Parinaud’s occuloglandular syndrome
– ocular granuloma, conjunctivitis or rarely, an ocular polyp (this thing is disgusting!), with associated parotid area swelling and pre-subauricular lymphadenopathy.