Difference between revisions of "Cat scratch disease"
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| Caption = Cat scratch disease. [[H&E stain]]. | | Caption = Cat scratch disease. [[H&E stain]]. | ||
| Micro = necrotizing granulomas with neutrophils and star-shaped (stellate, +/-multinucleated giant cells, microorganisms consistent with B. henselae | | Micro = necrotizing granulomas with neutrophils and star-shaped (stellate), +/-multinucleated giant cells, microorganisms consistent with ''B. henselae'' | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[sporotrichosis]], [[lymphogranuloma venereum]], [[tularemia]] | | LMDDx = [[sporotrichosis]], [[lymphogranuloma venereum]], [[tularemia]] | ||
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==General== | ==General== | ||
*Infection caused ''[[Bartonella henselae]]'',<ref name=pmid19332922>{{Cite journal | last1 = Jerris | first1 = RC. | last2 = Regnery | first2 = RL. | title = Will the real agent of cat-scratch disease please stand up? | journal = Annu Rev Microbiol | volume = 50 | issue = | pages = 707-25 | month = | year = 1996 | doi = 10.1146/annurev.micro.50.1.707 | PMID = 8905096 }}</ref> a gram-negative | *Infection caused ''[[Bartonella henselae]]'',<ref name=pmid19332922>{{Cite journal | last1 = Jerris | first1 = RC. | last2 = Regnery | first2 = RL. | title = Will the real agent of cat-scratch disease please stand up? | journal = Annu Rev Microbiol | volume = 50 | issue = | pages = 707-25 | month = | year = 1996 | doi = 10.1146/annurev.micro.50.1.707 | PMID = 8905096 }}</ref> a gram-negative bacillus (0.3-1.0 x 0.6-3.0 micrometers) in chains, clumps, or singular.<ref name=Ref_ILNP110>{{Ref ILNP|110}}</ref> | ||
*Treatment: antibiotics. | *Treatment: antibiotics. | ||
==Clinical== | ===Clinical=== | ||
Features:<ref name=Ref_ILNP113>{{Ref ILNP|113}}</ref> | Features:<ref name=Ref_ILNP113>{{Ref ILNP|113}}</ref> | ||
*Usually unilateral. | *Usually unilateral lymphadenopathy. | ||
**May be disseminated in individuals with immune dysfunction. | **May be disseminated in individuals with immune dysfunction. | ||
*Contact with cats. | *Contact with cats. | ||
==Gross== | |||
*Lymphadenopathy - usu. unlitateral. | |||
**Typically axillary or cervical (like [[tularemia]]).<ref name=pmid22706525>{{Cite journal | last1 = Asano | first1 = S. | title = Granulomatous lymphadenitis. | journal = J Clin Exp Hematop | volume = 52 | issue = 1 | pages = 1-16 | month = | year = 2012 | doi = | PMID = 22706525 }}</ref> | |||
==Micrograph== | ==Micrograph== | ||
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***Microabscesses often described as "stellate" (star-shaped). | ***Microabscesses often described as "stellate" (star-shaped). | ||
*+/-Multinucleated giant cells. | *+/-Multinucleated giant cells. | ||
*Microorganism consistent with ''B. henselae''. | |||
Notes: | Notes: | ||
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==Stains== | ==Stains== | ||
*Warthin-Starry stain +ve. | *[[Warthin-Starry stain]] +ve -- bacilli. | ||
*[[Gram stain]] -ve. | |||
==IHC== | ==IHC== | ||
*B. henselae IHC stain +ve - '''diagnostic'''. | *B. henselae IHC stain +ve -- bacilli - '''diagnostic'''. | ||
==See also== | ==See also== | ||
Latest revision as of 01:56, 4 January 2014
| Cat scratch disease | |
|---|---|
| Diagnosis in short | |
 Cat scratch disease. H&E stain. | |
|
| |
| LM | necrotizing granulomas with neutrophils and star-shaped (stellate), +/-multinucleated giant cells, microorganisms consistent with B. henselae |
| LM DDx | sporotrichosis, lymphogranuloma venereum, tularemia |
| Stains | Warthin-Starry stain +ve |
| IHC | B. henselae +ve |
| Site | lymph node - see lymph node pathology |
|
| |
| Clinical history | contact with cats |
| Signs | fever, lymphadenopathy |
| Prevalence | rare |
| Prognosis | benign |
| Clin. DDx | other causes of lymphadenopathy, e.g. lymphoma |
Cat scratch disease, also cat scratch fever, is an uncommon pathology of the lymph node.
General
- Infection caused Bartonella henselae,[1] a gram-negative bacillus (0.3-1.0 x 0.6-3.0 micrometers) in chains, clumps, or singular.[2]
- Treatment: antibiotics.
Clinical
Features:[3]
- Usually unilateral lymphadenopathy.
- May be disseminated in individuals with immune dysfunction.
- Contact with cats.
Gross
Micrograph
Features:[3]
- Necrotizing granulomas with:
- Neutrophils present in microabscess (necrotic debris) - key feature.
- Microabscesses often described as "stellate" (star-shaped).
- Neutrophils present in microabscess (necrotic debris) - key feature.
- +/-Multinucleated giant cells.
- Microorganism consistent with B. henselae.
Notes:
- May involve capsule or perinodal tissue.
DDx of stellate abscess in lymph nodes - cat split:[5]
- Cat-scratch disease.
- Sporotrichosis.
- Lymphogranuloma venereum.
- Tularemia.
Images
www:
CSD - very low mag. - showing serpentine shaped microabscesses (WC)
CSD - low mag. - showing serpentine shaped microabscesses (WC)
CSD - high mag. - showing neutrophilic abscesses (WC)
Stains
- Warthin-Starry stain +ve -- bacilli.
- Gram stain -ve.
IHC
- B. henselae IHC stain +ve -- bacilli - diagnostic.
See also
References
- ↑ Jerris, RC.; Regnery, RL. (1996). "Will the real agent of cat-scratch disease please stand up?". Annu Rev Microbiol 50: 707-25. doi:10.1146/annurev.micro.50.1.707. PMID 8905096.
- ↑ Ioachim, Harry L; Medeiros, L. Jeffrey (2008). Ioachim's Lymph Node Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 110. ISBN 978-0781775960.
- ↑ 3.0 3.1 Ioachim, Harry L; Medeiros, L. Jeffrey (2008). Ioachim's Lymph Node Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 113. ISBN 978-0781775960.
- ↑ Asano, S. (2012). "Granulomatous lymphadenitis.". J Clin Exp Hematop 52 (1): 1-16. PMID 22706525.
- ↑ URL: http://www.dermpathmd.com/mnemonics/mnemonics_dermatopathology.htm. Accessed on: 23 September 2011.