Cat-scratch disease in children at a medical center.
BACKGROUND
Cat-scratch disease (CSD) is a well-recognized, benign, self-limited regional lymphadenopathy occurring in immunocompetent patients. Several retrospective studies have demonstrated that CSD occurs at all ages, however, the disease appears to be more common in children. We conducted a retrospective case study of CSD in children presenting at our hospital, and reviewed the relevant literature.


METHODS
The medical records for eight children (age range 4-13 years) diagnosed with cat-scratch disease at the Tri-service General Hospital in Taipei from September 1, 1986 to September 1, 2002 were retrospectively reviewed. Clinical manifestations, diagnostic methods, and treatment types were assessed.


RESULTS
The male gender predominated (75%); the median age was 8.6 years. The latency period ranged from 7 days to 1 month, with a median diagnostic interval of 8.5 days. There were no deaths. All patients had lymphadenopathy, and the axillary node was the most prevalent site (62.5%). The most common locations for the scratch or inoculation lesions were the hands and/or fingers (62.5%). Three patients were diagnosed from clinical symptoms and history (37.5%), three from serological study (37.5 %), and two using biopsy or aspiration (25%). All patients were given antibiotic treatment. The most commonly used antibiotic was gentamicin (75%), with the average duration of treatment 8.7 days. The average hospital stay was 8 days, with the lymph-node size reduced relative to pretreatment baseline in all except one case.


CONCLUSIONS
In our experience, the long-term prognosis for children with typical CSD is favorable, and gentamicin may be a good antibiotic option.
Lien
Shao-Hung
SH
Department of Pediatrics, Tri-service General Hospital, National Defence Medical Center, Taipei, Taiwan.
Lo
Wen-Tsung
WT
Lee
Chuen-Ming
CM
Cheng
Shin-Nan
SN
Chu
Mong-Ling
ML
Wang
Chih-Chien
CC
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy; D002372:Cat-Scratch Disease / Q000175:diagnosis* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006761:Hospitals; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012196:Review Literature as Topic; D012867:Skin / Q000473:pathology
D000900:Anti-Bacterial Agents