Difference between revisions of "Cat scratch disease"

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#redirect [[Lymph_node_pathology#Cat-scratch_disease]]
'''Cat scratch disease''', also '''cat scratch fever''', is an uncommon [[lymph node pathology|pathology of the lymph node]].
 
==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 bacilla (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.
 
==Clinical==
Features:<ref name=Ref_ILNP113>{{Ref ILNP|113}}</ref>
*Usually unilateral.
**May be disseminated in individuals with immune dysfunction.
*Contact with cats.
 
==Micrograph==
Features:<ref name=Ref_ILNP113>{{Ref ILNP|113}}</ref>
*Necrotizing granulomas with:
**Neutrophils present in microabscess (necrotic debris) - '''key feature'''.
***Microabscesses often described as "stellate" (star-shaped).
*+/-Multinucleated giant cells.
 
Notes:
*May involve capsule or perinodal tissue.
 
DDx of stellate abscess in lymph nodes - ''cat split'':<ref name=pmid>URL: [http://www.dermpathmd.com/mnemonics/mnemonics_dermatopathology.htm http://www.dermpathmd.com/mnemonics/mnemonics_dermatopathology.htm]. Accessed on: 23 September 2011.</ref>
*Cat-scratch disease.
*[[Sporotrichosis]].
*[[Lymphogranuloma venereum]].
*[[Tularemia]].
 
===Images===
www:
*[http://www.webpathology.com/image.asp?case=386&n=1 Cat-scratch disease (webpathology.com)].
*[http://www.webpathology.com/image.asp?n=2&Case=386 Cat-scratch disease - high mag. (webpathology.com)]
<gallery>
Image:Cat_scratch_disease_-_very_low_mag.jpg | CSD - very low mag. - showing serpentine shaped microabscesses (WC)
Image:Cat_scratch_disease_-_low_mag.jpg | CSD - low mag. - showing serpentine shaped microabscesses (WC)
Image:Cat_scratch_disease_-b-_high_mag.jpg | CSD - high mag. - showing neutrophilic abscesses (WC)
</gallery>
 
==Stains==
*Warthin-Starry stain +ve.
 
==IHC==
*B. henselae IHC stain +ve - '''diagnostic'''.
 
==See also==
*[[Lymph node pathology]].
 
==References==
{{Reflist|2}}
 
[[Category:Diagnosis]]
[[Category:Lymph node pathology]]

Revision as of 19:49, 14 December 2013

Cat scratch disease, also cat scratch fever, is an uncommon pathology of the lymph node.

General

  • Infection caused Bartonella henselae,[1] a gram-negative bacilla (0.3-1.0 x 0.6-3.0 micrometers) in chains, clumps, or singular.[2]
  • Treatment: antibiotics.

Clinical

Features:[3]

  • Usually unilateral.
    • May be disseminated in individuals with immune dysfunction.
  • Contact with cats.

Micrograph

Features:[3]

  • Necrotizing granulomas with:
    • Neutrophils present in microabscess (necrotic debris) - key feature.
      • Microabscesses often described as "stellate" (star-shaped).
  • +/-Multinucleated giant cells.

Notes:

  • May involve capsule or perinodal tissue.

DDx of stellate abscess in lymph nodes - cat split:[4]

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.

IHC

  • B. henselae IHC stain +ve - diagnostic.

See also

References

  1. ↑ 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.
  2. ↑ Ioachim, Harry L; Medeiros, L. Jeffrey (2008). Ioachim's Lymph Node Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 110. ISBN 978-0781775960.
  3. ↑ 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.
  4. ↑ URL: http://www.dermpathmd.com/mnemonics/mnemonics_dermatopathology.htm. Accessed on: 23 September 2011.
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