Cat Scratch Disease (with a Case Report)

An initial local lesion in the skin together with a regional lymphadenitis, sometimes with formation of sterile pus following a scratch or bite by a cat is now being described as a separate disease entity. Originally recognised by Fosllay and Debre (Editorial, 1952) independently, a large number of cases has now been reported, mainly from France and U.S.A. and occasionally from other European countries. A case has also been reported in England (Jarai, 1952). Contact with a cat is more or less constant and the infection is transmitted most often by a scratch and less often by a bite. Contact with articles contaminated with cat's urine has also been reported to cause the disease. The disease starts with an 'initial lesion' in the skin at the site of the scratch. The initial lesion or primary lesion may be an inflammed scratch, or a raised papule covered with a scale and sometimes with a collection of pus underneath. It develops 3 to 7 days after the scratch. Soon after the primary lesion the regional glands enlarge. They are usually tender and inflammed with cedema of the overlying skin. Suppuration may occur. The commonest site for the glandular enlargement is the axillary region. They may enlarge to the size of an orange. The interval between the primary lesion and the adenitis may be as short as 3 days or as long as 30 days and the enlargement lasts from 2 weeks to 6 weeks or longer.