SINCE the first report by Debré in 1950 of a syndrome of regional lymphadenopathy after a cat scratch, a number of publications reporting several hundred cases have firmly established cat scratch disease as a clinical entity. The role of the cat in the natural history of the disease is not clearly understood, but the available evidence suggests the cat acts as a vehicle of transmission of an infectious agent although its role as a reservoir of infection has not been completely ruled out. The usual method of transmission appears to be inoculation of the agent at the site of a cat scratch, but other possible methods of transmission such as inhalation of the agent are substantiated by the several reported cases with a history of contact with cats but with no definite history of a scratch.
Daniels and MacMurray in 1954 reported an analysis of 160 cases, and in 1955 Kalter and associates summarized 250 cases which had come under their observation. Both of these reports gave excellent descriptions of the clinical features of the illness and this paper has drawn heavily upon their observations.
The primary feature of the clinical syndrome of cat scratch disease is lymphadenopathy which is usually regional and restricted to the drainage area of the site of the inoculation. Involvement of the lymph nodes of the upper extremity after inoculation on the hand or arm is most frequently observed. Cervical or inguinal involvement is not uncommon and occasionally generalized lymphadenopathy has been reported. The nodes are usually quite large, ranging up to several centimeters in diameter.
- Copyright © 1958 by the American Academy of Pediatrics