Bartonella species are slow growing, intracellular, Gram-negative rods

-Bartonella henselae causes cat-scratch disease 

Symptoms & Signs 

-The primary lesion: a painless erythematous papule or pustule at the inoculation site 

-Febrile lymphadenitis involving Axillary/epitrochlear nodes,head/neck/inguinal/femoral nodes 

-Fever, anorexia, malaise, encephalitis with CNS involvement

Diagnosis 

Serologic testing, PCR, culture and identification using Warthin-Starry silver impregnation stain 

Treatment 

– CSD is often a self-limited illness

-Antibiotics not routinely indicated

-for patients with severe disease, consider azithromycin