Cat scratch disease: no longer a diagnostic dilemma.

Cat scratch disease is a relatively common cause of localized lymphadenopathy with about 80% of cases occurring in children. This self-limited infection is caused by a small pleomorphic gram-negative bacillus that has been identified in ocular granulomas, skin and lymph node specimens. Unusual manifestations of the disease, such as the oculoglandular disease of Parinaud, encephalopathy, or severe systemic disease, occur in about 12% of patients. Management consists of symptomatic treatment, occasionally aspiration of a node or selected antibiotic therapy in moderate to severely ill patients. Persistence of adenopathy for several months in a generally healthy patient with gradual, spontaneous resolution of the enlarged node is the natural course.