Cat Scratch Disease
Joseph Misdraji, MD
Key Facts
Terminology
Self-limited infection by Bartonella species after inoculation by cat
Clinical Issues
Most cases are children 5-10 years of age
25% of patients with hepatic CSD have lymphadenopathy, but often classical skin papule is absent
Presence of hepatic nodules, with splenic nodules and lymphadenopathy in some cases, raises concern for neoplasia
Microscopic Pathology
Irregular, stellate microabscesses surrounded by layer of palisading histiocytes, lymphocytes, and rim of fibrous tissue
 Hematoxylin & eosin stained section of a liver wedge excision shows several nodules of granulomatous inflammation  with stellate abscesses and fibrosis. |
 Hematoxylin & eosin stained section shows stellate microabscesses at various stages of evolution, including young lesions with central necrosis  and older, more fibrotic lesions  . |
TERMINOLOGY
Abbreviations
Cat scratch disease (CSD)
Synonyms
Bartonellosis
Definitions
Self-limited infection by Bartonella species after inoculation by cat
Usually presents as local skin reaction and lymphadenopathy
Visceral involvement is rare
ETIOLOGY/PATHOGENESIS
Infectious Agents
Most cases are attributed to B. henselae but B. quintana has been implicated in some
CLINICAL ISSUES
Epidemiology
Age
Most cases are children 5-10 years of age
