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Limping in children: look what the cat dragged in!
  1. Christophe F Chantrain1,
  2. Caroline Genin2
  1. 1Paediatric Haematology Oncology, Department of Paediatrics, Centre Hospitalier Chrétien (CHC), Clinique de l’Espérance, Liège, Belgium
  2. 2Pediatric Infectious Disease, Department of Paediatrics, Centre Hospitalier Chrétien (CHC), Clinique de l’Espérance, Liège, Belgium
  1. Correspondence to Professor Christophe F Chantrain, Paediatric Haematology Oncology, Department of Paediatrics, Centre Hospitalier Chrétien (CHC), Clinique de l’Espérance, Montegnée B-4420, Belgium; christophe.chantrain{at}chc.be

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Cats are great companions for children and families. But cats are also a major reservoir for Bartonella henselae (Bh), an intracellular Gram-negative bacillus recognised as the causative agent of cat scratch disease (CSD). Up to half of domestic cats have antibodies against Bh.1 They are contaminated through cat fleas and transmit Bh to humans by saliva and scratches. Kittens, outdoor cats and cats infested with fleas represent the main vectors for human infection. However, the absence of cat in the environment or the lack of scratch history does not exclude the diagnosis of CSD. A lower proportion of healthy dogs has been found to be immune to Bh but their role in CSD remains unclear.1

Typically, patients with CSD present with subacute regional lymphadenitis associated or not with mild fever. Lymphadenopathy is most frequently found in the axillary and epitrochlear nodes (46%), head and neck (26%) and groin (17.5%). This reflects the fact that cat contacts are most often with the hands.1 Lymphadenitis tends to resolve spontaneously within a few weeks although surgical drainage may be necessary in 12%–16% of cases.2 Less common manifestations such as prolonged fever, hepatosplenic lesions, neurological disorders, neuroretinitis, Parinaud oculoglandular syndrome and …

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