Cat-scratch Disease Update

The article by Carithers, "Cat-scratch Disease Associated With an Osteolytic Lesion,"¹serves to remind us of the diverse presentations of cat-scratch disease (CSD), such as encephalitis, osteomyelitis, thrombocytopenic purpura, and/or the oculoglandular syndrome of Parinaud.¹⁻³Such articles should stimulate and encourage both clinicians and researchers to increase their efforts to isolate and characterize the causal agent of CSD.⁴,⁵Isolation of the cat-scratch bacillus would facilitate a prompt diagnosis of CSD in the patient with an atypical presentation of CSD (Table). Clinical diagnosis of classic CSD is not difficult when the patient has a typical clinical presentation, ie, tender regional lymphadenopathy, history of cat contact and/or scratch, and presence of a primary inoculation lesion as seen in 95% of Carithers' 1,000 patients and 61% of our 807 patients.¹,³ Carithers uses four major criteria to diagnose typical CSD: (1) lymphadenopathy, (2) history of cat contact and/or scratch,