From the Guidelines
Cat scratch fever, or cat scratch disease, is typically treated with azithromycin, which has been shown to reduce lymph node size by 80% at 30 days in treated patients compared to placebo 1. The recommended dose of azithromycin is 500 mg on day 1, followed by 250 mg once daily for 4 additional days for patients weighing ≥45.5 kg, and 10 mg/kg orally on day 1, then 5 mg/kg on days 2–5 for those weighing <45.5 kg 1. Some key points to consider in the treatment of cat scratch disease include:
- The disease is caused by Bartonella henselae, which enters the body through cat scratches or bites 1
- Symptoms can include a papule or pustule at the site of the scratch, followed by lymphadenopathy, which typically resolves within 1–6 months 1
- Extranodal disease can occur in ≤2% of cases, and bacillary angiomatosis can occur in immunocompromised patients 1
- Diagnosis can be difficult due to the fastidious nature of the organism, but serological testing, PCR, and Warthin-Starry silver stain of infected lymph node tissue can support the diagnosis 1
- Treatment with azithromycin has been shown to be effective in reducing lymph node size and improving symptoms 1
From the Research
Treatment for Cat Scratch Fever
The treatment for cat scratch fever, also known as cat-scratch disease, varies depending on the severity of the infection.
- Most cases of cat-scratch disease are self-limited and do not require antibiotic treatment 2, 3, 4.
- However, in some cases, antibiotic therapy may be necessary to speed up recovery or to treat more severe infections 2, 3, 4, 5, 6.
- Azithromycin has been shown to be effective in treating cat-scratch disease, with one study demonstrating that it can speed up recovery 2, 4, 5.
- Other antibiotics that have been used to treat cat-scratch disease include erythromycin, doxycycline, gentamicin, and rifampin 3, 4, 6.
- The choice of antibiotic and the duration of treatment depend on the severity of the infection and the patient's overall health 3, 4, 6.
- In some cases, supportive care may be necessary to manage symptoms such as fever, fatigue, and lymphadenopathy 3, 5.
- It is essential to note that cat-scratch disease can present in different forms, including Parinaud's oculoglandular syndrome, and may require specific treatment approaches 5.