title: Cat scratch disease: analysis of 130 seropositive cases.
abstract: To clarify the clinical manifestations of cat scratch disease (CSD), we evaluated a total of 130 seropositive patients with CSD. The patients' ages ranged from 1 to 68 years; 103 (79.2%) were under 18 years of age. CSD occurred predominantly in the fall and winter months. Regional lymphadenopathy was noted in 110 (84.6%) of the cases, and the most common sites were the neck (33%), axillary (27%), and inguinal (18%) regions. One hundred of the patients (77%) had general symptoms, such as fever, headache, and malaise. The clinical manifestations of CSD showed a wide spectrum from typical or classical CSD, with regional lymphadenopathy, to atypical or systemic CSD. Of the 130 cases, 103 (79.2%) were typical CSD and 27 (20.8%) were atypical CSD. Atypical cases of CSD were commonly reported as fever of unknown origin (37.0%), neuroretinitis (22.2%), encephalopathy (14.8%), hepatosplenic granuloma (11.1%), and Parinaud's oculoglandular syndrome (7.4%). Fever of unknown origin or prolonged fever lasting more than 14 days was evident in 27 (20.8%) of the 130 cases in this study. Eleven of the 27 cases lacked lymphadenopathy. Our findings suggest that CSD is not a rare disease in Japan. The indirect fluorescent antibody (IFA) test to detect Bartonella species may provide a prompt diagnosis of CSD and facilitate appropriate therapy.
authors.affiliation: Department of Pathology, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8554, Japan. k.mura@yamaguchi-u.ac.jp
authors.forename: Kyoko
authors.initials: K
authors.lastname: Murakami
authors.forename: Masato
authors.initials: M
authors.lastname: Tsukahara
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Tsuneoka
authors.forename: Hidechika
authors.initials: H
authors.lastname: Iino
authors.forename: Chizuru
authors.initials: C
authors.lastname: Ishida
authors.forename: Kumiko
authors.initials: K
authors.lastname: Tsujino
authors.forename: Akiko
authors.initials: A
authors.lastname: Umeda
authors.forename: Tomoko
authors.initials: T
authors.lastname: Furuya
authors.forename: Shigeto
authors.initials: S
authors.lastname: Kawauchi
authors.forename: Kohsuke
authors.initials: K
authors.lastname: Sasaki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood; D002372:Cat-Scratch Disease / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D002415:Cats; D002648:Child; D002675:Child, Preschool; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged
chemical_list: D000907:Antibodies, Bacterial