Cat-scratch disease

Cat-scratch disease (CSD) was first described by Debre in 1950, yet the cau sative bacterial agent of CSD remained obscure until 1992, when Bartonella (formerly Rochalimaea) henselae was implicated in CSD by serological and mi crobiologic studies. Bartonella henselae had initially been linked to bacil lary angiomatosis (BA), a vascular proliferative disease most commonly asso ciated with long-standing human immunodeficiency virus infection or other s ignificant immunosuppression. Bartonella henselae has also been associated with bacillary peliosis, relapsing bacteraemia and endocarditis in humans. Cats are healthy carriers of B. henselae, and can be bacteraemic for months or years. Cat-to-cat transmission of the organism by the cat flea, with no direct contact transmission, has been demonstrated. Two new Bartonella spe cies have been identified in the cat reservoir, namely: B. clarridgeiae and B. koehlerae. The role of these species in the aetiology of CSD still need s to be confirmed by isolation or DNA identification from lesions in humans . The author discusses the present state of knowledge on the aetiology, cli nical features and epidemiological characteristics of CSD/BA, in addition t o diagnosis, treatment and prevention.