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Members of the health care professions who examine the head and neck regions should be familiar with cat scratch disease and consider it in a differential diagnosis. This article summarizes the history, literature, diagnosis, and treatment of cat scratch disease.
A case of cat scratch disease with a submental mass as the initial symptom has been presented. The disease should be considered in the evaluation of swellings and masses of the cervicofacial region. However, because of the benign course of cat scratch disease, other more serious disease processes must be ruled out before establishing the diagnosis of cat scratch disease.
Fourteen patients are presented to illustrate the usefulness of ultrasonography in assessing masses of the neck. Included are five patients with primary tumors, two with metastasis to a cervical node, three with cervical adenitis, two with simple cysts, and two with hematoma related to endarterectomy for occlusive disease of the carotid artery.
Fifty cat scratch disease patients were tested for antibodies against candidate etiological agents, with inconclusive results. Future research should emphasize new viral isolation methods to discover the elusive agent.
The authors describe the fibro-granulomatous lesions with scar formation on a splenectomy specimen removed for familial spherocytosis, eight weeks after the onset of cat scratch disease. This original observation, apparently unique in the literature, is in favour of the blood spread of the agent responsible for benign inoculation lymphoreticulosis, and suggests a pathogenic theory for the unusual visceral manifestations.
Pets are not a major source of human infections but they can transmit certain diseases to man. This transmission usually is complex, requiring close contact with pets or their excretions and frequently involves a breach of sound hygienic practice. In some instances, pathogens of animal origin are acquired inadvertently because infectivity can persist after evidence of gross contamination has gone. Veterinarians participate in controlling zoonotic diseases by encouraging rabies vaccination and hygienic treatment of pet feces and urine, by supporting community efforts toward responsible pet ownership and by advising on precautions for handling sick animals. It is recommended that veterinarians discourage the keeping of wild or exotic animals as pets and excess fondling of pets (particularly by children and pregnant women). Clients and kennel workers should be advised to use caution with animals that have aborted.
Sub-plasmalemmal linear densities of variable length (0.1 approximately 1.0 mu) were found to be a constant feature of globoid cells in human as well as in canine globoid cell leukodystrophy (GLD). Similar densities were also observed in experimental globoid cells and epithelioid cells in chronic granuloma but not in glial cells. The linear densities always appeared without any relation to basal laminae. These observations together with the other reports of similar structures in lymphoma, fibroma and sarcoidosis suggest that the sub-plasmalemmal density is a structure frequently observed in mesenchymal cells, and may be another supporting feature for possible mesenchymal origin of globoid cells.
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A causative agent ("D" strain) was isolated from the contents of an affected lymph node of a patient with beningn lymphoreticulosis. According to the biological and antigenic properties this agent is identified with Chlamydia but is a distinct species. The chlamydial etiology of benign lymphoreticulosis is determined also by the complement-fixation test with sera from convalescents.
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A case of cat scratch disease, presenting as a parotid tumor, is described. In its oculo-glandular form, this disease may be associated with swelling of the intraparotid lymph nodes, and the possibility should be considered in the differential diagnosis of parotid tumors in children. A careful history, and skin testing with cat scratch antigen, may aid in the diagnosis of this condition.