Cat scratch disease was first described in 1931, but its causative agent, Bartonella henselae, was not isolated until 1992 from the blood of a domestic cat. The disease is widespread and is characterized by great variability in clinical manifestations.

Human infection occurs through stripes, cat bites and close contact with animals. It is also suggested that infection of people can occur directly with the bite of fleas, like animals. Owners of kittens under 12 months of age have been shown to be 15 times more likely to develop the disease than owners of adult cats.

Cat scratch disease can occur in a typical or atypical form, regardless of the patient's immune status. Typical manifestations in immunocompetent individuals include the presence of a reddish, painless papule after 3 to 10 days at the site of animal damage. After 1-3 weeks, a unilateral regional lymphadenopathy develops. The disease progresses slowly. Patients are generally in a satisfactory state, with mild and non-specific manifestations, such as anorexia, malaise, arthralgia, myalgia or abdominal pain. The duration of the infectious process generally does not exceed 6 months.

The main atypical manifestation of feline claw disease is Parino syndrome, represented by unilateral pre-atrial lymphadenopathy and conjunctivitis. On the conjunctiva of the eyelids, red-yellow nodules of 2-3 mm appear, which is equivalent to an inoculation papule. Pathological changes are completely resolved in the absence of treatment.

Uncertain fever, weeks and months that last, and hepatosplenal symptoms serve as an indicator of the spread of the infection. In some groups of individuals, CACs account for up to 5% of cases of fever of unknown origin. These patients have a high ESR, however, abdominal pain and lymphadenopathy are seen in less than half of the cases.

The sudden onset of back pain indicates the development of vertebral osteomyelitis caused by B. henselae. Clinical and radiological recovery in the absence of treatment occurs within a few months. Cat scratch disease often manifests as the development of endocarditis, requiring heart surgery followed by antibiotics for several months.

Neurological complications of the infection include Leber's stellar neuroretinitis, which is characterized by rapid, painless vision loss in one eye. When retinoscopy in the macular region reveals a "star shape". Recovery occurs within a few weeks or months. Another serious complication of an infection requiring hospitalization in the intensive care unit and in intensive care is the development of encephalopathy. The condition progresses from a headache to a coma within a few hours. Recovery also occurs quickly, as a rule, patients do not have permanent damage, but the occurrence of focal seizures or prolonged stay in a coma are unfavorable prognostic signs.

Patients with immunodeficiency conditions may develop bacillary angiomatosis and peliosis. The B. henselae infection stimulates endothelial vasoproliferation, which leads to the formation of large, painful tumors of the skin, connective tissue, bones, bone marrow, respiratory or gastrointestinal tract , lymph nodes and brain. With severe immunodeficiency, large hemorrhagic cysts can form in the liver and spleen. The main complaint of patients is a prolonged increase in body temperature, weakness and gastrointestinal manifestations.

In the diagnosis of cat scratch disease, anamnesis (contact with animals) and identification of traumatic injuries caused by cats play an important role. In addition to the rashes, the pathognomonic symptoms of the infection are a prolonged increase in body temperature and lymphadenopathy. The diagnosis is confirmed by serological, cultural, histological or PCR studies.

The most reliable and most used serological test is ELISA, the sensitivity of which reaches 88%, the specificity 94%. A single detection of antibodies directed against B. henselae in a titer greater than 1/512 or a quadrupling of the titer in 2 to 4 weeks is a diagnostic criterion for an acute infection. Although a titer greater than 1/64 is considered positive, in some individuals it may be a sign of a previous infection. A PCR study has significant advantages over histology and culture and allows the identification of genotypes of pathogens.

Feline claw disease in immunocompetent individuals is prone to self-healing; in the absence of therapy, resolution occurs after 1-3 months. In patients with immunodeficiency during the atypical course of the disease, prolonged antibiotic therapy may reduce the risk of death.

Moderate acceleration of lymphadenopathy resolution has been observed with azithromycin treatment. Other potentially effective antibiotics for this infection include other macrolides, rifampicin, doxycycline, gentamicin, trimethoprim / sulfamethoxazole and ciprofloxacin (as monotherapy or a combination of the two).

The bacteremia caused by B. henselae persists in kittens for weeks and months, even when specific antibacterial drugs are prescribed. Most adult cats develop a protective immune response, the mechanism of which is unknown. Vaccination, therapy of cats, as well as their routine cultural or serological examination are considered irrational.