Which physical findings are characteristic of bartonellosis (Bartonella infection)-related catscratch disease?

Updated: Jun 19, 2019
  • Author: Kassem A Hammoud, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Enlarged lymph glands develop 1 week to 2 months after exposure. Swollen tender nodes are the usual presenting symptom.

Careful examination of the interdigital spaces, skin creases, and scalp increases the chance of finding the primary inoculation lesion. Inoculation sites other than the skin include the eye and mucous membranes (oral ulcer).

One third to two thirds of patients develop low-grade fever that lasts several days.

B henselae infection is one of the common causes of fever of unknown origin and prolonged fever in children. One study showed that the absence of lymphadenopathy in patients with catscratch disease was closely related to the presence of prolonged fever or systemic complications. Another study of 186 patients with a serological diagnosis of catscratch disease showed that 30 (16.1%) patients had no regional lymphadenopathy. These patients had persistent fever and more frequent systemic complications than patients with lymphadenopathy. [22, 23, 24]

Malaise and fatigue are common. Many patients feel healthy except for the enlarged node or nodes. Patients occasionally have multifocal lymphadenopathy.

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