From the Guidelines
The treatment for cat scratch disease is azithromycin, which is recommended as 500 mg on day 1 followed by 250 mg for 4 additional days for patients >45 kg, and 10 mg/kg on day 1 and 5 mg/kg for 4 more days for patients <45 kg. This recommendation is based on the guidelines for the diagnosis and management of skin and soft tissue infections, including cat scratch disease, as outlined by the Infectious Diseases Society of America 1. The use of azithromycin has been shown to be effective in reducing lymph node size and improving symptoms in patients with cat scratch disease 1.
Some key points to consider when treating cat scratch disease include:
- The disease is caused by the bacterium Bartonella henselae, which is transmitted through cat scratches or bites.
- Symptoms can range from mild to severe and may include lymphadenopathy, fever, and fatigue.
- Treatment with azithromycin has been shown to be effective in reducing symptoms and improving outcomes.
- It is essential to complete the full course of antibiotics, even if symptoms improve, to ensure complete recovery.
- Preventing future infections involves washing hands after handling cats and promptly cleaning any scratches or bites with soap and water.
In terms of diagnosis, cat scratch disease can be challenging to diagnose due to the fastidious nature of the bacterium and the difficulty of growing it in culture 1. Serological testing and PCR can be useful in supporting the diagnosis, and a positive Warthin-Starry silver stain of infected lymph node tissue can confirm the diagnosis. However, the primary treatment approach remains focused on antibiotic therapy with azithromycin, as recommended by the guidelines 1.
From the Research
Treatment for Cat Scratch Disease
The treatment for cat scratch disease (CSD) varies depending on the severity of the infection and the individual's immune status.
- For immunocompetent individuals, CSD is usually a self-limited illness that does not require antibiotic therapy 2, 3, 4, 5.
- However, for severe or persistent cases, several antibiotics have been shown to be effective, including:
- In one study, azithromycin therapy was associated with more rapid diminution in size of infected lymph nodes 2.
- For immunocompromised individuals, antibiotic therapy is often necessary to prevent serious complications, such as bacillary angiomatosis and relapsing bacteremia with fever syndrome 2, 3.
- In general, the majority of cases of CSD do not require anti-infective therapy for resolution of infection, and conservative, symptomatic treatment is recommended for mild or moderate cases 6, 5.