Cat-Scratch Disease in Texas

In mid-1995, the Texas Department of Health initiated an investigation of patients with suspected cat-scratch disease. From April 1992 through May 1995, sera from 371 Texas patients were tested by the CDC for antibody to Bartonella species. Based on questionnaire responses from physicians of 51 patients who had positive Bartonella henselae indirect fluorescence antibody test results, the most common disease manifestations were lymphadenopathy (78.4%), fever (56.9%), and a rash/papule at the site of inoculation (19.6%). The most common "atypical" presentation was encephalopathy (9.8%), followed by seizures (7.8%) and neuroretinitis (5.9%). Most of the patients (85.4%) were younger than 18 years; 74.5% were exposed to cats and 39.2% had a history of either a cat bite or scratch.