The illness of the claws of the cat (ICC)

The illness of the claws of the cat (ICC) has been described for the first time in 1889 by H. Parinaud like an infectious conjunctivitis, transmitted by the animals, coming with a strong ganglionarian reaction. The pathogenic agent is a bacillus negative Gram, Bartonella Henselae. The responsible vectors in the transmission of the illness are the fleas, the contamination making itself by a scratch or a bite of a cat or by the sting of an infected flea. The classic clinical picture includes the adenopathia, the fever (38-41°C), the tiring, the headaches, the splenomegalia and the cutaneous demonstrations to type of rash transient maculo-papulose. Other rarer demonstrations have been noted: neurological attack with encephalitis or attack of the peripheral nerves, ophthalmic attack (oculoglandularian syndroma of Parinaud), pulmonary attack, cardiovascular attack, hepatomegalia, purpura thrombopenic, knotted erythema. Outside of the clinical picture, the diagnosis rests on the serology (indirect immunofluorescence or enzymatic immuno-assay with titration of the IgG antibodies or IgMs), the exam anatomopathologique of the adenopathy watch of the typical lesions but non specific (hyperplasia lymphoïdic, granulomes with gigantic cells, micro-abscess) and the polymerase chain reaction (PCR) done on valvular biopsies or adénopathies.

The prévalence of the ICC is of 6,6 (1,8 to 9,3) cases for 100000 inhabitants.

The peak of impact seems to be located between 30 and 50 years, 75% of the cases being returned during the cold period of the year, between September and April.

The sex men / women ratio is 3/2.

The prognosis is excellent at the patient immunocompetent, with a spontaneous resolution in 90% of the cases, an antibiotherapia being however necessary in case of immunodepression, as well as in the neurological and cardiac shapes.

Author: Dr C. Henegar (January 2004).