It is important to emphasize that a negative antibody test result does not exclude the diagnosis, especially early in the clinical course. Laboratory confirmation of the diagnosis can be challenging, as the sensitivity and specificity of serologic tests (such as an indirect fluoresence assay or enzyme immunoassay), which are the standard method of diagnosis, are variable. Laboratory studies usually are not needed in a patient with classic disease and an epidemiologic history that includes contact with a cat (particularly if the patient was scratched by a kitten). What laboratory studies should you request to help confirm the diagnosis? How should you interpret the results? They then may develop regional lymphadenopathy 1 to 3 weeks after inoculation. What caused this disease to develop at this time?Īfter inoculation of the bacteria via a cat scratch, patients often develop an erythematous papule 3 to 10 days later at the site of the scratch. In the first few days of illness, the differential diagnosis includes acute bacterial lymphadenitis. Non-infectious diseases that may present with similar manifestations include malignancies and autoimmune diseases. Primarily, this means other granulomatous infections such as Mycobacterium tuberculosis as well as non-tuberculous mycobacteria, fungi, nocardia, and actinomyces. The differential diagnosis of cat scratch lympadenopathy includes other causes of subacute or chronic lymphadenopathy. What other disease/condition shares some of these symptoms?
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