The Cat Scratch Disease. !!
La enfermedad por arañazo de gato. !!
ACTUALIZADO 2017 - 2024
EDITORIAL ENGLISH
===================
Hello friends of the network. DERMAGIC EXPRESS Again with a very
interesting topic about pets, in this case the cute kittens. Today's topic
THE CAT SCRATCH DISEASE (SCD) Transmitted Zoonotic Disease by the bite or
scratches of our pets, cute kittens.
The causal agent of this
disease is the Bacteria Bartonella Henselae, according to the scientists
more than half of the cats are carriers of the same. The bacterium is
transmitted from cat to cat by cat flea Ctenocephalides felis.
The
disease begins as a papule at the site of inoculation. Which is
transformed into pustule and later a regional infadenopathy with local
symptoms. The disease can heal spontaneously but can give more severe
manifestations among which they stand out:
Long-Term Complications of Cat Scratch Disease
Chronic Lymphadenopathy:
In some cases, lymph nodes may remain swollen for months or
even years after the initial infection. This can cause discomfort and
require medical follow-up.
Disseminated Infections:
In severe cases, Bartonella henselae can spread to other
organs, such as the liver, spleen, lungs, and central nervous system. This
can result in more serious complications, such as hepatitis or
pneumonia.
Ocular Complications:
CSD can
cause eye problems, such as retinitis, which can lead to vision loss if
not treated properly. This is more common in immunocompromised people.
Parinaud's oculoglandular syndrome, neuroretinitis, uveitis.
Neurological Symptoms:
Rarely, the disease can affect the nervous system, causing
symptoms such as confusion, seizures, or encephalitis.
Persistent Fatigue:
Some people may experience prolonged fatigue and malaise that
persists long after other symptoms have disappeared.
Arthritis:
Although rare, some patients may develop arthritis or joint
pain as a result of the infection.
In summary:
GENERAL: Discomfort. Fever, anorexia, weight loss.
SKIN:
Subcutaneous nodules and abscesses.
HIGAGO: Granulomatous
hepatitis, Hepatomegaly, hepatic abscess.
BAZO: Splenomegaly,
splenic abscesses.
BRAIN: Encephalitis, meningitis, seizures
SPINAL
CORD: transverse myelitis.
HEART: Endocarditis.
BLOOD:
Bacteremia
EYE: Parinaud's oculoglandular syndrome,
neuroretinitis, uveitis.
The Bartonella Hanselae also produces
another disease called bacillary angiomatosis, which is seen more in
immunocompromised patients.
Treatment:
Treatment options for cat scratch disease are:
1.) Local Heat Application:
This measure is recommended in the affected area to relieve pain
and inflammation.
2.) Analgesics:
to relieve pain and inflammation.
3.) Antibiotics: The literature states that they are not always necessary, but the
better way is to administer antibiotics to prevent the spread of
infection, and the eligible ones are; azithromycin or doxycycline to help
reduce the inflammation of the lymph nodes and shorten the duration of
symptoms.
However, its use is controversial and is not
considered essential in all cases.
In a study of 268 patients
with this pathology, the effectiveness of 4 (four) antibiotics was
demonstrated: they were rifampicin 87%, ciprofloxacin 84%,
trimethoprim-sulfamethoxazole 58%. Intramuscular gentamicin sulfate was
73% effective.
In cases where lymph node suppuration is
present, intranodal injection of gentamicin has been used successfully.
In
cases of ocular involvement, topical drops of 0.5% ketorolac twice a day
and 0.05% difluprednate four times a day have been used for more than 6
weeks.
4.) In immunosuppressed patients(HIV/AIDS) or autoimmune diseases:
treatment should be more aggressive:
Apart from the classic analgesics and local measures (heat),
antibiotic therapy should be mandatory: azithromycin, doxycycline,
rifampicin or gentamicin, ciprofloxacin, trimethoprim-sulfamethoxazole.
The
incidence of CAT SCRATCH DISEASE disease in the United States between 2005
and 2013 in children between 5 and 9 years of age was 9.4 cases per
100,000 population. The most affected age group was 50 to 64 years. About
12.000 new cases are estimated each year, of which 500 are
hospitalized.
The best preventive measure, control the flea of
the cat and of course avoid the biting or scratches of the cute
kittens.
Through these 49 references you will know the
disease, its complications and the therapeutic alternatives.
In the
attachment, the cat, the child, the initial papule and the posterior
lymphadenopathy.
Greetings to all.
Dr. José
Lapenta
EDITORIAL ESPAÑOL
==================
Hola amigos de la red. De nuevo el DERMAGIC EXPRESS con un tema bien interesante sobre las mascotas, en este caso los lindos gatitos. El tema de hoy LA ENFERMEDAD POR ARAÑAZO DE GATO.
Enfermedad Zoonótica transmitida por la mordedura o arañazos de nuestras
mascotas, lindos gatitos. El agente causal de esta enfermedad es la
bacteria Bartonella Henselae, según los científicos mas de la mitad de los
gatos son portadoras de la misma. La bacteria es transmitida de gato a
gato por la pulga del gato Ctenocephalides felis.
La enfermedad comienza como una pápula en el sitio de la inoculación. la
cual se transforma en pústula y posteriormente una linfadenopatia regional
con síntomas locales. La enfermedad puede sanar espontáneamente pero puede
dar manifestaciones mas severas entre las que destacan:
Complicaciones a Largo Plazo de la Enfermedad por Arañazo de Gato
Linfadenopatía Crónica:
En algunos casos,
los ganglios linfáticos pueden permanecer inflamados durante meses o
incluso años después de la infección inicial. Esto puede causar molestias
y requerir seguimiento médico.
Infecciones Diseminadas:
En casos severos, la Bartonella henselae puede diseminarse a
otros órganos, como el hígado, el bazo, los pulmones y el sistema nervioso
central. Esto puede resultar en complicaciones más graves, como hepatitis
o neumonía.
Complicaciones Oculares:
La CSD
puede causar problemas oculares, como la retinitis, que puede llevar a la
pérdida de visión si no se trata adecuadamente. Esto es más común en
personas inmunocomprometidas. Síndrome óculo glandular de Parinaud, neuro retinitis, uveítis.
Síntomas Neurológicos:
En raras ocasiones, la
enfermedad puede afectar el sistema nervioso, causando síntomas como
confusión, convulsiones o encefalitis.
Fatiga Persistente:
Algunas personas pueden experimentar fatiga prolongada y
malestar general que persiste mucho después de que otros síntomas han
desaparecido.
Artritis:
Aunque es poco común,
algunos pacientes pueden desarrollar artritis o dolor articular como
resultado de la infección.
Resumiendo:
GENERALES: Malestar. fiebre, anorexia, perdida de peso.
PIEL: Nódulos subcutaneos y abscesos.
HIGAGO: Hepatitis granulomatosa, Hepatomegalia, absceso hepático.
BAZO: Esplenomegalia, abscesos esplénicos.
CEREBRO: Encefalitis, meningitis, convulsiones
MÉDULA ESPINAL: mielitis transversa.
CORAZÓN: Endocarditis.
SANGRE: Bacteriemia
OJO: Síndrome óculo glandular de Parinaud, neuro retinitis,
uveítis.
La Bartonella Henselae también produce otra enfermedad denominada
angiomatosis bacilar, la cual se observa mas en pacientes
inmunocomprometidos.
Tratamiento:
las opciones de tratamiento para la enfermedad por arañazo de
gato son:
1.) Aplicación de Calor Local:
Esta medida se recomienda en la zona afectada para aliviar el dolor
y la inflamación.
2.) Analgésicos: para aliviar el dolor e inflamación.
3.) Antibióticos: La literatura refiere que no siempre son necesarios, pero lo
ideal es administrar antibióticos para evitar la diseminasion de la
infección, y los elegibles son; azitromicina o doxiciclina para ayudar a
reducir la inflamación de los ganglios linfáticos y acortar la duración de
los síntomas.
Sin embargo, su uso es controvertido y no se considera
esencial en todos los casos.
En un estudio de 268 pacientes con esta patología se demostró la
efectividad de 4 (cuatro) antibióticos: ellos fueron rifampicina 87%,
ciprofloxacino 84%, trimetoprim-sulfametoxazol 58%. El sulfato de
gentamicina intramuscular tuvo una eficacia del 73%.
En los
casos donde se presenta supuración de los ganglios linfáticos se ha
utilizado con éxito la inyección intra-nodal de gentamicina.
En
casos de afección ocular se ha utilizado gotas tópicas de ketorolaco al
0,5 % dos veces al día y difluprednato al 0,05 % cuatro veces al día
durante más de 6 semanas.
4.) En pacientes inmunodeprimidos (VIH/SIDA) o enfermedades
autoinmunes
el tratamiento debe ser mas agresivo:
Aparte de los clásicos analgésicos y medidas locales (calor), la
antibiótico terapia debe ser obligatoria: azitromicina, doxiciclina,
rifampicina o gentamicina, ciprofloxacino, trimetoprim-sulfametoxazol.
La incidencia de la enfermedad por ARAÑAZO DE GATO EN los Estados Unidos
entre 2.005 y 2.013 en niños entre 5 y 9 años de edad fue de 9,4 casos por
100.000 habitantes. El grupo etario mas afectados fue de 50 a 64 años. Se
estiman unos 12.000 casos nuevos al año, de los cuales 500 son
hospitalizados.
la mejor medida preventiva, controlar la pulga del gato y por supuesto
evitar la mordedura o arañazos de los lindos gatitos.
A través de estas 49 referencias conocerás la enfermedad, sus
complicaciones y las alternativas terapéuticas.
En el adjunto, el gato, el niño, la pápula inicial y la posterior
linfadenopatia.
Saludos a todos,,,
Dr. José Lapenta R.,,,
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REFERENCIAS BIBLIOGRÁFICAS / BIBLIOGRAPHICAL REFERENCES
================================================================
1.) The Cat-Scratch Disease.
2.) Cat scratch disease: detection of
Bartonella henselae DNA in archival biopsies from patients with
clinically, serologically, and histologically defined disease.
3.)
[A case of cat scratch disease identified by an elevated Bartonella
henselae antibody level using enzyme immunoassay]
4.) Will the
real agent of cat-scratch disease please stand up?
5.) [Cat
scratch disease caused by Bartonella henselae]
6.)
Hypercalcemia due to endogenous overproduction of active vitamin D in
identical twins with cat-scratch disease.
7.) Cat-scratch
disease caused by Bartonella henselae: the first case report in
Taiwan.
8.) [Cat-scratch disease and other infections caused by
Bartonella species]
9.) Bartonella spp. as emerging human
pathogens.
10.) [Bartonella henselae infection in immunocompetent
patients: cat scratch disease]
11.) Cat-scratch disease and
related clinical syndromes.
12.) Cat-scratch disease and
bacillary angiomatosis.
13.) Detection of antibodies to
Bartonella henselae in clinically diagnosed cat scratch disease.
14.)
The expanding spectrum of Bartonella infections: II. Cat-scratch
disease.
15.) Evaluation of serological response to Bartonella
henselae, Bartonella quintana and
Afipia felis antigens in 64
patients with suspected cat-scratch disease.
16.) [Cat scratch
disease and associated infections]
17.) Cat-scratch disease
simulating Histiocytosis X.
18.) [Atypical cat-scratch disease:
a case report of splenic granulomatosis]
19.) [2 patients with
atypical manifestations of cat-scratch disease]
20.) [Visceral
localizations of cat-scratch disease in an immunocompetent
patient]
21.) Serous retinal detachment of the macula
associated with cat scratch disease.
22.) Cat scratch disease
in Greece.
23.) Cat-scratch disease--an overlooked disease in
Denmark?]
24.) Prolonged Bartonella bacteremia in cats associated
with cat-scratch disease patients.
25.) Application of
polymerase chain reaction assay in the diagnosis of orbital granuloma
complicating atypical oculoglandular cat scratch disease.
26.)
Systemic cat scratch disease: hepatic and splenic involvement about 3
pediatric cases.
27.) Bartonella clarridgeiae, a newly
recognized zoonotic pathogen causing inoculation papules, fever, and
lymphadenopathy (cat scratch disease).
28.) Coinfection with
Bartonella clarridgeiae and Bartonella henselae and with different
Bartonella henselae strains in domestic cats.
29.) [Cat-scratch
disease: historical, clinical, phylogenetic and taxonomic aspects]
30.)
Molecular diagnosis of cat scratch disease: a two-step approach.
31.)
Antibiotic therapy for cat-scratch disease: clinical study of therapeutic
outcome in 268 patients and a review of the literature.
32.)
Successful treatment of cat-scratch disease with ciprofloxacin [see
comments].
33.) Diverse Clinical Signs of Ocular Involvement in Cat Scratch
Disease.
34.) Cat Scratch Disease: Expanded Spectrum.
35.)
Dynamics of Co-Infection with Bartonella henselae Genotypes I and II in
Naturally Infected Cats: Implications for Feline Vaccine Development.
36.)Bacillary
angiomatosis with bone invasion.
37.) Molecular epidemiology of
bartonella infections in patients with bacillary angiomatosis-peliosis.
38.)
Corticosteroid Treatment for Prolonged Fever in Hepatosplenic Cat-Scratch
Disease.
39.) Final Diagnosis in Patients Referred with a Diagnosis
of Neuroretinitis.
40.) Disseminated cat-scratch disease: case report
and review of the literature.
41.) Multiple Renal and Splenic Lesions
in Cat Scratch Disease.
42.) Cat-Scratch Disease in the United
States, 2005-2013. 43.) Cat fleas (Ctenocephalides felis) from cats and
dogs in New Zealand: Molecular characterisation, presence of Rickettsia
felis and Bartonella clarridgeiae and comparison with Australia.
43.)
Cat fleas (Ctenocephalides felis) from cats and dogs in New Zealand:
Molecular characterisation, presence of Rickettsia felis and Bartonella
clarridgeiae and comparison with Australia.
================================================================
44.) Effectiveness of Antibiotic Therapy in Pediatric Patients With
Cat Scratch Disease.
45.) Cat-Scratch Disease.
46.) Antibiotic Therapy for Cat-Scratch Disease: Clinical Study of
Therapeutic Outcome in 268 Patients and a Review of the Literature.
47.) Hepatosplenic Cat-Scratch Disease in Children: Selected Clinical
Features and Treatment.
48.) Intra-Nodal Injection of Gentamicin for the Treatment of
Suppurated Cat Scratch Disease's Lymphadenitis.
49) Case Report: Treatment of Severe Neuroretinitis and Other
Sequelae Associated With Cat Scratch Disease.
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