August 1984

Cat-scratch Disease Update

Author Affiliations

Department of Pediatrics Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine 4301 Jones Bridge Rd Bethesda, MD 20814

Am J Dis Child. 1984;138(8):711-713. doi:10.1001/archpedi.1984.02140460003003

The article by Carithers, "Cat-scratch Disease Associated With an Osteolytic Lesion,"1 serves to remind us of the diverse presentations of cat-scratch disease (CSD), such as encephalitis, osteomyelitis, thrombocytopenic purpura, and/or the oculoglandular syndrome of Parinaud.1-3 Such articles should stimulate and encourage both clinicians and researchers to increase their efforts to isolate and characterize the causal agent of CSD.4,5 Isolation of the cat-scratch bacillus would facilitate a prompt diagnosis of CSD in the patient with an atypical presentation of CSD (Table). Clinical diagnosis of classic CSD is not difficult when the patient has a typical clinical presentation, ie, tender regional lymphadenopathy, history of cat contact and/or scratch, and presence of a primary inoculation lesion as seen in 95% of Carithers' 1,000 patients and 61% of our 807 patients.1,3

Carithers uses four major criteria to diagnose typical CSD: (1) lymphadenopathy, (2) history of cat contact and/or scratch,

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