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Is my daughter's fever due to cat scratch disease?

Q: My 14 months old daughter is suffering from high fever (102 F) for the past four days. She has no cold like symptoms. We have got her ears, throat and urine examination done, but nothing is wrong. Today she woke up with a temperature of 104 F. We took her to the hospital and they sent us home asking me to check for dehydration. I am really worried. I have thoughts that it could be cat scratch fever. I have a cat at home and she gets scratches from him all the time. I never knew there was such a thing as cat scratch fever till I found it on the Internet. What should I do? What could be the cause of high fever with no cold symptoms?

A:Cat scratch disease is a self-limiting infection caused by a bacillus called Bartonella henselae. It is transmitted to cats by the bite of a flea and cats act as reservoir for the disease. Though most people get the disease from cats, it may also be caused after exposure to dogs, goats, squirrels, and even barbed wire. There is usually a history of bite or scratch to the head, neck, or upper limb. Within a few days there may be a small skin lesion and by 2 weeks the local lymph gland becomes enlarged and painful. This may be accompanied by malaise &/or loss of appetite. Fever occurs in about 1/3rd individuals. The diagnosis is made by testing the blood for IgG and IgM antibodies. The presence of IgM antibodies suggests recent infection but low levels may persist for more than a year following an infection. IgG antibody is suggestive of current or past infection. Generally, no treatment is required as the disease resolves spontaneously but antibiotics may be needed if complicated skin infections are present. Other conditions like mononucleosis, TB, chronic granulomatous disease etc. need to be excluded.

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