Cat scratch disease

Japanese: 猫ひっかき病 - ねこひっかきびょう（英語表記）Catscratch disease
Cat scratch disease

What is the disease?

Cat scratch disease is caused by being scratched by a cat or dog. Create ( yes ) Bacteria can infect wounds or bites, causing redness and swelling. neck ( Keibu ) This disease causes symptoms such as pain and swelling of the lymph nodes and fever. It occurs more frequently from summer to autumn.

What is the cause?

This disease is caused by infection with the Bartonella genus bacteria, which are found on the nails and in the mouths of animals such as cats and dogs, as well as in cat fleas that parasitize animals.

In Japan, 10% of cats are infected and carry the bacteria, and it is believed that most human infections are caused by cats. The risk of infection from kittens in particular has been pointed out.

How symptoms manifest

After an incubation period of several days to several weeks, the following symptoms usually appear:

①Skin symptoms (occurrence rate 50-90%)

Skin symptoms appear first. Typically, small red or pus-filled bumps measuring 2-5 mm in diameter appear. Scab ( Souvenir ) (Scabs) form.

② Swollen lymph nodes (occurrence rate 80-90%)

Painful, swollen lymph nodes appear in the armpits, neck, and jaw. The swollen lymph nodes may become larger than the size of a chicken egg. The lymph nodes are hard and painful, but gradually soften and often break open, releasing pus. The rash and swollen lymph nodes resolve on their own within 2 to 5 months.

3) Fever (occurrence rate: 50-70%)

④Other

Encephalopathy (occurrence rate less than 10%) causing headaches and impaired consciousness conjunctivitis ( Ketsumakuen ) It may also be accompanied by diabetes and Cirrhosis ( Sightseeing ) The condition often becomes severe in children and those with underlying conditions that weaken the immune system.

Testing and diagnosis

It is diagnosed based on 1) a history of contact with cats or dogs, 2) unknown swelling of the lymph nodes that continues for more than three weeks, 3) unknown fever, and 4) histopathological findings.

Treatment methods

① In adults, the condition usually resolves naturally, so the patient is observed over time with only symptomatic treatment using antipyretics and analgesics. The prognosis is generally good, and the patient will recover within 6 to 12 weeks without the use of antibiotics.

②If symptoms persist, take antibiotics orally.

③Severe cases may require hospitalization or treatment in an intensive care unit.

What to do if you notice an illness

Please visit a dermatologist, internal medicine specialist, or pediatrician. If your child has a loss of consciousness, a severe headache, or is unable to eat, please call an ambulance.

Kiyotsugu Takuma

Cat scratch disease
Catscratch disease (CSD)
(Infectious Diseases)

What is the disease?

It is transmitted by being scratched or bitten by a cat. It is caused by a bacterium called Bartonella henselae. It is most common in young children and adolescents.

It is believed that the bacteria in cat flea feces settles in the mouth and claws of cats through grooming, and then spreads to other cats or to humans when the cat licks, scratches, or bites the wound. It has also been pointed out that there is a possibility of infection directly from fleas.

How symptoms manifest

After an incubation period of 3 to 10 days, Erythematous maculopapular rash ( Public health emergency ) and painful lymph nodes swelling ( Chief ) (Swelling) is observed. Fever, chills, loss of appetite, Fatigue ( Health test ) , generalized rash, Parinaud syndrome ( Vertical gaze palsy ( Swimming pool ) ) may be accompanied by

It is generally a benign disease and in most cases will heal naturally. However, in patients with weakened immune systems, it can cause liver and spleen ( Hizo ) Bacterial hemangiomas can occur in these areas, and serious complications such as encephalopathy have also been reported.

Testing and diagnosis

A definitive diagnosis is made by serological diagnosis, isolation of the bacterium, or detection of the gene by the polymerase chain reaction (PCR) method. Tularemia ( Yato Hospital ) , lymphoma, toxoplasmosis, etc. must be distinguished.

Treatment methods

If the immune system is normal, the disease will usually heal naturally, so antibiotic treatment is not necessary. For patients with immune disorders or severe cases, treatment is with drugs such as azithromycin, doxycycline, and ciprofloxacin.

What to do if you notice an illness

If your pet is injured by a cat, clean and disinfect the affected area immediately. Usually, the injury will heal naturally, but keep an eye on it and seek medical help if it does not heal.

Akio Yamada

Cat scratch disease
Catscratch disease (CSD)
(Childhood illnesses)

What is the disease?

It gets its name from the fact that the lymph nodes swell after being scratched by a cat, but there are also cases where it develops after being scratched by a dog, and in other cases the cause is unknown.

What is the cause?

It is caused by infection with a bacterium called Bartonella, which is carried by cats and other animals.

How symptoms manifest

In typical cases, the lymph nodes, mainly in the neck, become swollen 1 to 2 weeks after being scratched by a cat. In many cases, fever also develops. Complications are rare, but in rare cases, encephalopathy and eye inflammation may occur.

Testing and diagnosis

Bartonella is difficult to culture, so symptoms and a history of contact with cats are what make this disease suspect.

Treatment methods

Antibiotics that are effective against Bartonella are used. In many cases, the condition will heal naturally, but in that case, it may take several months for the swelling in the lymph nodes to go down.

What to do if you notice an illness

If the lymph nodes in your neck swell after being scratched by a cat, it is almost certain that you have this condition, but there are also cases where the history of contact with cats is unknown. Therefore, if the swelling in your lymph nodes in your neck does not go away, you may have this disease, so please consult a medical institution.

Tomohiro Oishi

Source: Houken “Sixth Edition Family Medicine Encyclopedia” Information about the Sixth Edition Family Medicine Encyclopedia

Japanese:

どんな病気か

　猫ひっかき病は、ネコやイヌに引っかかれた創(そう)（傷）や咬まれた創から細菌が感染し、赤くはれ、頸部(けいぶ)のリンパ節の痛み・はれ、発熱などの症状を来す疾患です。夏から秋にかけて発生頻度が高くなります。

原因は何か

　バルトネラ属の菌が感染することにより発症します。この菌はネコやイヌなどの動物の爪や口腔内、あるいは動物に寄生するネコノミなどに存在します。

　日本ではネコの1割が感染し保菌しており、ヒトへの感染のほとんどはネコによるものと考えられます。とくに子ネコからの感染の危険性が指摘されています。

症状の現れ方

　通常、数日～数週間の潜伏期のあと、次の症状があります。

①皮膚症状（出現率5～9割）

　最初に皮膚症状が現れます。典型例では直径2～5㎜の小さな赤い発疹、あるいはうみをもった発疹、瘡蓋(そうがい)（かさぶた）を生じます。

②リンパ節のはれ（出現率8～9割）

　痛みのあるリンパ節のはれが、腋の下や頸部、下顎に現れます。リンパ節のはれは鶏卵大以上になることもあります。リンパ節は硬く、押すと痛みがありますが徐々に軟らかくなり、しばしば一部が破れてうみが流れ出ます。発疹やリンパ節のはれは2～5カ月で自然に治ります。

③発熱（出現率5～7割）

④その他

　頭痛や意識障害を訴える脳症（出現率1割以下）や結膜炎(けつまくえん)を合併することもあります。また、糖尿病や肝硬変(かんこうへん)など免疫力の低下を伴う基礎疾患がある場合や小児では、しばしば重症になります。

検査と診断

　①ネコやイヌとの接触歴、②原因不明で3週間以上継続するリンパ節のはれ、③原因不明の発熱、④組織病理学的所見により診断されます。

治療の方法

①成人では、通常は自然に治るため、解熱薬や鎮痛薬の対症療法だけで経過観察します。一般に予後は良好で、抗菌薬を使わなくても6～12週でよくなります。

②症状が長引く場合には抗菌薬を内服します。

③重症例では入院や集中治療室での治療が必要になります。

病気に気づいたらどうする

　皮膚科、内科、あるいは小児科を受診してください。また、意識障害や重度の頭痛、あるいは食事ができない時は、救急車を要請してください。

田熊　清継

猫ひっかき病
ねこひっかきびょう
Catscratch disease (CSD)
(感染症)

どんな病気か

　ネコにひっかかれたり、咬まれたりすることによって感染します。原因は、バルトネラ・ヘンセレという細菌です。幼児や思春期の子どもに多く発症します。

　ネコノミの糞中の細菌が、毛づくろいなどによってネコの口腔や爪に定着し、傷口をなめたり、ひっかいたり、咬んだりすることでネコ同士あるいはヒトへの感染が起こると考えられています。ノミから直接感染する可能性も指摘されています。

症状の現れ方

　3～10日の潜伏期ののち、受傷部位に紅斑性丘疹(こうはんせいきゅうしん)が現れ、リンパ節の有痛性の腫脹(しゅちょう)（はれ）が認められます。発熱、寒気、食欲不振、倦怠感(けんたいかん)、全身の発疹、パリノー症候群（垂直注視麻痺(すいちょくちゅうしまひ)）などを伴うことがあります。

　一般的には良性の病気で、多くの場合は自然に治ります。しかし、免疫機能の低下している患者さんでは、肝臓、脾臓(ひぞう)などに細菌性血管腫を起こすことがあり、また、脳症などの重い合併症も報告されています。

検査と診断

　血清学的診断あるいは菌の分離、PCR（ポリメラーゼ連鎖反応）法による遺伝子の検出などによって確定診断します。臨床的にはブルセラ症、野兎病(やとびょう)、リンパ腫、トキソプラズマ症などとの区別が必要です。

治療の方法

　免疫機能が正常であれば、通常は自然に治るので、抗生剤による治療は行いません。免疫異常の患者さんや重症の場合にはアジスロマイシン、ドキシサイクリン、シプロフロキサシンなどの薬で治療を行います。

病気に気づいたらどうする

　ネコによって傷つけられた場合には、患部をすみやかに洗浄して消毒します。通常は自然に治りますが、様子を観察し、治らないようなら医療機関を受診してください。

山田　章雄

猫ひっかき病
ねこひっかきびょう
Catscratch disease (CSD)
(子どもの病気)

どんな病気か

　ネコにひっかかれた後にリンパ節がはれるため、このような名前がついています。しかし、イヌにひっかかれて発症した例や、原因が不明な場合もあります。

原因は何か

　ネコなどがもっているバルトネラ菌という細菌の感染によります。

症状の現れ方

　典型例では、ネコにひっかかれた1～2週後に、主に首のリンパ節がはれてきます。また、多くの例では熱も出ます。合併症はほとんどありませんが、まれに脳症や眼の炎症を起こすことがあります。

検査と診断

　バルトネラ菌を培養することは難しく、症状およびネコとの接触歴からこの病気を考えます。

治療の方法

　バルトネラ菌に対して効果のある抗生剤を使います。自然に治ることも多いのですが、その場合、リンパ節のはれがひくのに数カ月もかかります。

病気に気づいたらどうする

　ネコにひっかかれた後に首のリンパ節がはれてきた場合はほぼ間違いないのですが、実際はネコとの接触歴が不明な例もあります。したがって、首のリンパ節のはれがなかなか治らない場合はこの病気にかかっている可能性もあるため、医療機関に相談してください。

大石　智洋

出典　法研「六訂版 家庭医学大全科」六訂版 家庭医学大全科について　情報

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