16: Bartonella Henselae (Cat-Scratch Disease)

Cat-scratch disease (CSD), the predominant clinical manifestation of Bartonella henselae infection, manifests in 85% to 90% of children as a localized cutaneous and regional lymphadenopathy disorder. A skin papule or pustule develops within 12 days at the presumed site of inoculation in approximately two-thirds of cases and usually precedes development of lymphadenopathy by 1 to 2 weeks (range, 7–60 days). Lymphadenopathy occurs in nodes that drain the site of inoculation, typically axillary, but cervical, submandibular, submental, epitrochlear, or inguinal nodes can be involved. Low-grade fever lasting several days develops in 30% of patients. The skin overlying affected lymph nodes can...