title: Cat scratch disease: The story continues.
abstract: OBJECTIVE
  To present a perspective on the current state of knowledge of cat scratch disease (CSD), including the evidence for Bartonella henselae as the etiological agent, epidemiological and clinical characteristics of the disease, available diagnostic tests and current therapeutic options.
  
  
  METHODS
  MEDLINE search of the literature published from 1966 to 1995 using 'cat scratch disease', 'Bartonella henselae', 'Rochalimaea henselae' as key words and bibliographies of selected papers.
  
  
  METHODS
  Selected studies reporting data on etiology, epidemiology, clinical characteristics, diagnosis and therapy of CSD were evaluated.
  
  
  CONCLUSIONS
  Evidence accumulated to date supports B henselae as the etiological agent of CSD. The most significant risk factors for CSD are being licked on the face, scratched or bitten by a kitten and owning a kitten with fleas. Available serological tests can confirm classic CSD and identify B henselae as the cause of more atypical presentations, such as fever of unknown origin, granulomatous hepatitis, encephalitis and osteomyelitis. Symptomatic management is appropriate for isolated lymphadenopathy caused by CSD in healthy individuals; however, antibiotic therapy may be indicated for patients with more severe manifestations of the disease and immunocompromised hosts. Further study of CSD, in particular the epidemiology and therapy, is warranted. A better understanding of the pathogenesis of B henselae infection will have important implications in both immunocompetent and immunocompromised individuals.
authors.affiliation: Winner of the Canadian Infectious Disease Society/Canadian Journal of Infectious Diseases Review Article Award; portions of this review have also been submitted as part of a Canadian Paediatric Society statement on cat scratch disease, The Hospital for Sick Children, Toronto, Ontario.
authors.forename: M A
authors.initials: MA
authors.lastname: Opavsky