Benign lymphoreticulosis (felinosis, cat scratch disease). What atypical symptoms may lymphoreticulosis manifest?

Felinosis is one of the infectious diseases whose source is cats. In this article we will look at the causes, symptoms, diagnosis and treatment. of this disease.

Felinosis - cat scratch disease in adults and children: causes, causative agent, symptoms

Sometimes beloved pets can become a source of disease. You should know what diseases you can get from cats in order to prevent unpleasant consequences for yourself and your loved ones. By the way, not only pets can infect their owners, stray or street cats can also pose a danger if you come into contact with them.

One of the diseases transmitted from cats to humans is felinosis. The name comes from the Latin word felinus, which means feline. The disease has several names. One of the names is disease cat scratches , it's simple.

Actually, the very name “cat scratch disease” speaks about the nature of this disease.

Important: Felinosis can occur if an animal bites or scratches a person. The infection does not spread between people.

A cat bite can cause felinosis

There is an infection on the cat's claws that penetrates into the dermis and causing development infectious process in the human body. The animal's saliva is also infected. It is especially dangerous when saliva gets on the mucous membrane of the eye.

The causative agent of the infection is a bacterium Bartonella henselae. Some scientists believe that this small gram-negative bacterium is part of the microflora oral cavity cats. This bacterium is also found in dogs, monkeys, and rodents. However, humans become infected precisely from cats.

Important: Studies have been conducted which have revealed that the majority of cats, including both indoor and outdoor cats, are infected Bartonella henselae.

It has been established that the carriers Bartonella henselae There are fleas among cats. It is during the season of the flea development cycle (autumn-summer period) that the greatest activity of the felinosis disease is recorded.

Cat scratch disease infection pattern

Symptoms of felinosis that should alert the suspected patient are:

Formation of nodular rash (papules) in places of bites and scratches
Inflammation of the lymph nodes

Cat scratch disease - benign lymphoreticulosis: how does it manifest, how to treat?

Lymphoreticulosis benign is another name for the disease. You can become infected at any age; after experiencing the disease, a strong immunity is developed.

Important: Studies have shown that 25% of cat owners have antibodies to the bacterium Bartonella henselae. This suggests that the disease passed unnoticed.

If a person strong immunity, the disease may go away on its own, and the symptoms will not be pronounced. Complications as a result of infection are observed in people with immunodeficiency.

Felinosis does not appear immediately. Incubation period averages 1-2 weeks. However, in some cases, the disease begins to manifest itself within 3 days after infection.

Cat scratch disease has three cycles:

Elementary
The height of the disease
Recovery period

Let's look at each cycle in turn.

For initial period The disease is characterized by the appearance of papules at the site of a scratch or bite. Papules can appear even when the scratch or bite is already healing. Papules in most cases do not itch or hurt, in other words, they do not cause discomfort to the patient.

initial stage felinosis

A couple of days after the initial period begins the height of the disease. The papules begin to fester, then open up, and crusts form in their place, which eventually disappear. There are no scars left after the papules dry. After another couple of weeks, inflammation of the lymph nodes begins, most often they are observed in armpits, and also on the neck. One lymph node may become inflamed. Sometimes the lymph nodes are quite enlarged and painful on palpation. During this period, a person's body temperature may rise. Felinosis is also dangerous because during its peak period intoxication of the body occurs, which can last up to 3 weeks.

Inflammation of the lymph nodes with felinosis

You can understand that a period of recovery has begun when the lymph nodes begin to return to normal, weakness and fever disappear.

Important: Recovery most often occurs spontaneously. However, in in rare cases felinosis occurs typical shape, in other words, it has a number of complications and is painful. In this case, you cannot do without the help of doctors.

Complications of cat scratch disease

Cat scratch disease - Bartonella: diagnosis, treatment

A preliminary diagnosis is made based on the combination of symptoms listed above. First, the doctor must rule out other diseases in which the lymph nodes become inflamed:

Infectious mononucleosis
tularemia
lymphomas

An accurate diagnosis is established after laboratory research. There are several methods that help accurately determine the presence of infection.

Treatment of cat scratch disease

Diagnostic methods, which help to identify the causative agent of felinosis:

Histology of lymph nodes
Serological diagnosis
Skin allergy tests
PCR method

In most cases, the disease is practically asymptomatic, and recovery occurs on its own. However, if the doctor diagnosed you with felinosis and prescribed drug treatment, you should not neglect them.

These help fight infection drugs:

Anti-inflammatory (indomethacin, diclofenac)
Antihistamines (Claritin, Zyrtec, Erius)
Antibiotics (doxycycline, erythromycin, bactrim).

Important: Antibacterial therapy is appropriate if severe course diseases. Antibacterial therapy is also prescribed for HIV-infected people. If abscesses have formed in the area of the lymph nodes, it is necessary surgical intervention.

Diagnosis of felinosis

Disease, cat scratch syndrome: treatment with folk remedies

Important: Folk remedies can be used in the treatment of felinosis only if the disease occurs in mild form. Treatment of a disease with complications should be carried out by a highly qualified doctor.

Folk remedies help relieve inflammation, relieve general state body, heal wounds.

The juice of fresh plants has disinfecting and regenerating properties:

Celandine
Calendula flowers
Yarrow
Nettles

Please note for good effect necessary only Fresh Juice . If you can find the juice from these plants, good. Obtaining fresh plant juice is not easy for known reasons.

If there is no juice, you will have to look for other methods of treating cat scratch disease. First emergency help in case of a bite or scratch you may provide:

Rinse the wound with normal laundry soap.
Wash the wound with alcohol or regular cologne, pour brilliant green.

First aid for a scratch

Affected areas can be wiped infusion of dried chamomile flowers which are sold in pharmacies.

At the same time, with felinosis, it is desirable to increase immunity. For this purpose the following is successfully used folk remedy, How echinacea tincture.

As you can see, having fun with our little brothers can turn out completely unpleasant situation. There is no specific prevention for this disease. The only thing that can be advised is not to touch unfamiliar street cats, and also to warn children against playing with them. If you are bitten or scratched by your a pet, treat the wound with an antiseptic and monitor the condition of the body over the next month. If symptoms of felinosis appear, seek help at the hospital.

Video: Cat scratch disease - felinosis

BENIGN LYMPHORETICULOSIS (CAT SCRATCH DISEASE, FELINOSIS)

Benign lymphoreticulosis - general infection, caused by a gram-negative rod from the family Bartonellaceae - B. henselae(Bartonella Hensel). The disease occurs when the pathogen penetrates through scratches or bites of a cat, and is manifested by moderately severe symptoms of intoxication, regional lymphadenitis, and often the formation of a primary affect at the site of penetration of the pathogen.

Epidemiology. The natural source of infection is rodents and birds. Cats are passive carriers of the pathogen. Only in rare cases do they develop the disease in an asymptomatic or erased form. It is also possible that it develops after damage to the skin and mucous membrane by bird feathers, bones, small chips, etc. Transmission of the infection directly from a sick person to a healthy person has not been proven. The disease is recorded throughout the year, with a maximum rise in the autumn-winter months, which is apparently associated with the migration of rodents to human homes, where they can be attacked by cats. Susceptibility to felinosis has not been established. Mostly children are affected. The diseases occur in sporadic cases. Familial outbreaks have been described.

Pathogenesis. The pathogen enters the human body through damaged skin, mucous membranes, and rarely through the conjunctiva, tonsils, Airways or gastrointestinal tract. A few days later on site entrance gate a primary affect occurs in the form of a dense papule, which can ulcerate and crust over. From the site of primary localization, the pathogen enters the regional lymph nodes through the lymphogenous route, where it intensively multiplies and releases toxin, resulting in adenitis. With further progression of the process, a breakthrough of the lymphatic barrier and hematogenous dissemination of the infection with damage to the liver, spleen, central nervous system and other organs are possible.

Pathomorphology.Biggest changes found in regional lymph nodes in close proximity to the primary affect. In this case, either one or a group of lymph nodes can be involved in the process. Lymph nodes are enlarged, moderately compacted and fused together. On a section they are dark red in color, homogeneous or with areas of necrosis and melting in accordance with the stage pathological process. On early stages the disease is dominated by hyperplasia reticular cells with gradual transformation into a granuloma consisting exclusively of epithelial cells. central part The granuloma undergoes necrosis and a microabscess is formed. Subsequently, microabscesses can merge, the process involves the entire lymph node, as well as the surrounding tissue - an inflammatory conglomerate is formed with a tendency to melt. At histological examination in foci of inflammation, clusters of giant multinucleated cells of the Berezovsky-Sternberg type are found. Morphological changes in benign lymphoreticulosis they do not differ in strict specificity; they may resemble changes in tularemia, brucellosis, tuberculosis, and lymphogranulomatosis. In most patients, necrotic masses undergo organization followed by resorption or partial sclerosis. Less commonly, the abscess opens and after removal of the pus, fast healing. In severe generalized forms, the granulomatous process is found in the brain (encephalitis), lungs (pneumonia), liver (hepatitis), bones (osteomyelitis), mesentery (adenitis), etc.

Clinical manifestations. The incubation period ranges from 10 to 30 days, sometimes extended to 2 months. The disease begins acutely, with an increase in temperature to 38-39 ° C, mild malaise and an increase in regional lymph node or groups of lymph nodes. The axillary and cervical lymph nodes are most often affected, less often the inguinal, femoral, and submandibular lymph nodes. Sometimes there is an unusual localization of adenitis: in the subclavian or supraclavicular region, in front auricle etc. The affected lymph nodes are enlarged to 10 cm in diameter, less often - up to 15 cm, they are moderately dense, inactive, sensitive or painful on palpation, and in 1/3 of patients they suppurate. Enlargement of regional lymph nodes can be considered leading clinical sign felinosis. Often the disease begins with regional lymphadenitis, and symptoms of intoxication appear later or are not expressed at all, and then adenitis becomes practically the only symptom of the disease. However, most patients at the height of the disease experience fever, headaches and muscle pain, and loss of appetite. In rare cases, intestinal dysfunction, scarlet-like, measles-like, erythematous or large-nodose skin rashes are possible. Very often, at the site of the entrance gate of infection (usually the arms, face, neck), a red papule is noted; sometimes you can see an ulcer, pustule, crust or an infiltrated, hyperemic and painful scratch from the cat’s claws. The primary affect appears long before regional lymphadenitis, so at the height of clinical manifestations, changes in the skin may be minimal or completely absent.

The described forms of felinosis are considered typical. Glandular-ocular, anginal, abdominal, pulmonary, cerebral are considered atypical and other rare forms of the disease. Clinical manifestations in them correspond to the lesion (conjunctivitis with regional lymphadenitis, pneumonia, tonsillitis, encephalitis, mesadenitis, etc.). Atypical forms also include erased and subclinical forms of the disease.

Changes in peripheral blood depend on the stage of the pathological process. The initial period is characterized by moderate leukocytosis with lymphocytosis and monocytosis. ESR without deviations from the norm. During the period of suppuration of the lymph nodes, leukocytosis can reach 15,000-25,000, neutrophilia with a shift to the left, eosinophilia and increased ESR are noted.

Diagnostics. The diagnosis of felinosis is established based on the detection of primary affect at the site of scratches or cat bites, regional lymphadenitis with a tendency to suppuration and a long torpid course, moderate symptoms of intoxication and changes in the peripheral blood.

The disease must be differentiated from bacterial lymphadenitis, lymphogranulomatosis, tuberculosis of the lymph nodes, and tularemia.

Treatment mostly symptomatic. In case of suppuration, it is recommended to remove the pus by puncture of the lymph node or incision. Assign antibacterial drugs(erythromycin, azithromycin, clindamycin) in age-specific doses for 5-7 days. However, the effectiveness antibacterial therapy low. Physiotherapeutic effects (UHF, diathermy) are applied to the area of the affected lymph nodes. In severe cases, corticosteroid drugs are used for a short course (5-7 days).

The prognosis is favorable.

Prevention. Avoid scratching and biting your cat. Specific prevention not developed.

Benign lymphoreticulosis(cat scratch disease, felinosis) is a common infectious disease caused by a gram-negative rod from the Bartonellaceae family - B. henselae (Hensel's Bartonella). The disease occurs when the pathogen penetrates through scratches or bites of a cat, and is manifested by moderately severe symptoms of intoxication, regional lymphadenitis, and often the formation of a primary affect at the site of penetration of the pathogen.
The natural source of infection is rodents and birds. Cats are passive carriers of the pathogen. Only in rare cases do they develop the disease in an asymptomatic or erased form. It is also possible that it develops after damage to the skin and mucous membrane by bird feathers, bones, small chips, etc. Transmission of the infection directly from a sick person to a healthy person has not been proven. The disease is recorded throughout the year, with a maximum rise in the autumn-winter months, which is apparently associated with the migration of rodents to human homes, where they can be attacked by cats. Susceptibility to felinosis has not been established. Mostly children are affected. The diseases occur in sporadic cases. Familial outbreaks have been described.
Pathogenesis. The pathogen enters the human body through damaged skin, mucous membranes, and rarely through the conjunctiva, tonsils, respiratory tract or gastrointestinal tract. After a few days, at the site of the entrance gate, a primary affect appears in the form of a dense papule, which can ulcerate and become covered with a crust. From the site of primary localization, the pathogen enters the regional lymph nodes through the lymphogenous route, where it intensively multiplies and releases toxin, resulting in adenitis. With further progression of the process, a breakthrough of the lymphatic barrier and hematogenous dissemination of the infection with damage to the liver, spleen, central nervous system and other organs are possible.
Pathomorphology. The greatest changes are found in regional lymph nodes in the immediate vicinity of the primary affect. In this case, either one or a group of lymph nodes can be involved in the process. Lymph nodes are enlarged, moderately compacted and fused together. On a section they are dark red in color, homogeneous or with areas of necrosis and melting in accordance with the stage of the pathological process. In the early stages of the disease, hyperplasia of reticular cells predominates with gradual transformation into a granuloma consisting exclusively of epithelial cells. The central part of the granuloma undergoes necrosis and a microabscess is formed. Subsequently, microabscesses can merge, the process involves the entire lymph node, as well as the surrounding tissue - an inflammatory conglomerate is formed with a tendency to melt. Histological examination reveals clusters of giant multinucleated cells of the Berezovsky-Sternberg type in foci of inflammation. Morphological changes in benign lymphoreticulosis are not strictly specific; they may resemble changes in tularemia, brucellosis, tuberculosis, and lymphogranulomatosis. In most patients, necrotic masses undergo organization followed by resorption or partial sclerosis. Less often, the abscess opens and after removal of the pus, rapid healing occurs. In severe generalized forms, the granulomatous process is found in the brain (encephalitis), lungs (pneumonia), liver (hepatitis), bones (osteomyelitis), mesentery (adenitis), etc.
Clinical manifestations. The incubation period ranges from 10 to 30 days, sometimes extended to 2 months. The disease begins acutely, with an increase in temperature to 38-39 ° C, mild malaise and enlargement of a regional lymph node or group of lymph nodes. The axillary and cervical lymph nodes are most often affected, less often the inguinal, femoral, and submandibular lymph nodes. Sometimes there is an unusual localization of adenitis: in the subclavian or supraclavicular region, in front of the auricle, etc. The affected lymph nodes are enlarged up to 10 cm in diameter, less often - up to 15 cm, they are moderately dense, inactive, sensitive or painful on palpation, in 1/3 the sick are festering. Enlargement of regional lymph nodes can be considered the leading clinical sign of felinosis. Often the disease begins with regional lymphadenitis, and symptoms of intoxication appear later or are not expressed at all, and then adenitis becomes practically the only symptom of the disease. However, most patients at the height of the disease experience fever, headaches and muscle pain, and loss of appetite. In rare cases, intestinal dysfunction, scarlet-like, measles-like, erythematous or large-nodose skin rashes are possible. Very often, at the site of the entrance gate of infection (usually the arms, face, neck), a red papule is noted; sometimes you can see an ulcer, pustule, crust or an infiltrated, hyperemic and painful scratch from the cat’s claws. The primary affect appears long before regional lymphadenitis, so at the height of clinical manifestations, changes in the skin may be minimal or completely absent.
The described forms of felinosis are considered typical. Glandular-ocular, anginal, abdominal, pulmonary, cerebral and other rare forms of the disease are considered atypical. Clinical manifestations in them correspond to the lesion (conjunctivitis with regional lymphadenitis, pneumonia, tonsillitis, encephalitis, mesadenitis, etc.). Atypical forms also include erased and subclinical forms of the disease.
Changes in peripheral blood depend on the stage of the pathological process. The initial period is characterized by moderate leukocytosis with lymphocytosis and monocytosis. ESR without deviations from the norm. During the period of suppuration of the lymph nodes, leukocytosis can reach 15,000-25,000, neutrophilia with a shift to the left, eosinophilia and increased ESR are noted.
Diagnostics. The diagnosis of felinosis is established based on the detection of primary affect at the site of scratches or cat bites, regional lymphadenitis with a tendency to suppuration and a long torpid course, moderate symptoms of intoxication and changes in the peripheral blood.
The disease must be differentiated from bacterial lymphadenitis, lymphogranulomatosis, tuberculosis of the lymph nodes, and tularemia.
Treatment of lymphoreticulosis. Treatment is predominantly symptomatic. In case of suppuration, it is recommended to remove the pus by puncture of the lymph node or incision. Antibacterial drugs (erythromycin, azithromycin, clindamycin) are prescribed in age-specific doses for 5-7 days. However, the effectiveness of antibacterial therapy is low. Physiotherapeutic effects (UHF, diathermy) are applied to the area of the affected lymph nodes.
In severe cases, corticosteroid drugs are used for a short course (5-7 days).
The prognosis is favorable.
Prevention. Avoid scratching and biting your cat. Specific prevention has not been developed.

The site administration does not evaluate recommendations and reviews about treatment, drugs and specialists. Remember that the discussion is being conducted not only by doctors, but also by ordinary readers, so some advice may be dangerous to your health. Before any treatment or use medicines We recommend contacting specialists!

COMMENTS

Yana Medved / 2015-03-09

STB TV channel is looking for a person suffering from lymphoreticulosis for a new medical project! We are ready to help you, free of charge - medical examination, consultation with specialists, assistance in raising funds for treatment! Write and call 0675232233 [email protected]

is a common infectious disease caused by Bartonella Hensel, a gram-negative rod from the family Vartoneliaceae- IN.henselae. The disease is also called felinosis or cat scratch disease.

The pathogen enters the child’s body through scratches or cat bites. The disease is accompanied by symptoms of moderate intoxication and regional lymphadenitis. Often, at the site of a cat's scratch, primary affect can be observed. This area becomes red and swells greatly.

Epidemiology

The infection is “stored” in the bodies of birds and rodents. Cats are passive carriers of the pathogen Bartonella Hensel. Only in extremely rare cases does their disease manifest itself in a mild or asymptomatic form.

A child can become infected with benign lymphoreticulosis if the skin or mucous membrane is damaged by bird feathers, bones, etc. It is not known for sure whether the infection is transmitted to children from a sick person. Cases of the disease are recorded all year round, with the greatest rise in the cold season (autumn and winter). It is believed that this is due to the fact that rodents migrate to human houses and dachas, where they are attacked by cats. Lymphoreticulosis mainly affects children; susceptibility is not precisely known. The disease is recorded in the form of sporadic isolated cases. There are cases when entire families fell ill.

What provokes / Causes of Benign lymphoreticulosis in children

The causative agent of benign lymphoreticulosis belongs to chlamydia. Their infectious particles are round shape, the size ranges from 250 to 300 nm. Infectious particles are found in macrophages and reticuloendothelial cells, have a similar development cycle, group antigen and the same chemical composition with the causative agent of diseases such as psittacosis and other diseases of the Chlomydozoaceae group.

Pathogenesis (what happens?) during Benign lymphoreticulosis in children

The pathogen enters the child’s body through damage to the skin and mucous membranes. In more rare cases, the entry gate is the conjunctiva, tonsils, gastrointestinal tract or respiratory tract.

At the site through which the infection entered, the so-called primary affect appears. It is a dense papule that can turn into an ulcer and become covered with a crust. Next, the causative agent of the disease through lymphatic vessels reaches the regional lymph nodes. There it actively multiplies, secretes a toxin, which leads to adenitis. If the process is not stopped, a breakthrough of the lymphatic barrier and hematogenous dissemination of the infection may occur, affecting the spleen, liver, central nervous system and other organs.

Pathomorphology

The biggest changes occur in the regional lymph nodes as close as possible to the primary affect. The process can affect either one lymph node or an entire group. In this case, the nodes are enlarged, moderately compacted and welded together. If you cut them, you can observe that inside they are dark red in color, homogeneous or with areas of necrosis and melting, depending on the stage at which the pathological process is located.

In the early stages of the disease, hyperplasia of reticular cells predominates with gradual transformation into a granuloma consisting exclusively of epithelial cells. The central part of the granuloma undergoes necrosis and a microabscess is formed. Next, microabscesses can merge, the process involves the entire lymph node, as well as the surrounding cells - an inflammatory conglomerate is formed with a tendency to melt.

Histological examination reveals accumulations of giant mononuclear cells of the Berezovsky-Sternberg type in areas of inflammation. Morphological changes in benign lymphoreticulosis are not specific; they are similar to those in brucellosis, tularemia, lymphogranulomatosis, and tuberculosis.

This disease sometimes occurs in a severe generalized form (affecting the entire body), then the granulomatous process “acts” in the brain (causing encephalitis), in the lungs (causing pneumonia), in the liver (causing hepatitis), in the bones (causing osteomyelitis) , in the mesentery (causing adenitis), etc.

Symptoms of Benign lymphoreticulosis in children

The incubation period lasts from 10 to 1 month - the period from infection to the appearance of the first symptoms. In some cases - 2 months. The disease has an acute onset, the temperature “jumps” to 38-39 °C. The sick child feels slightly unwell. A regional lymph node or group of nodes enlarges.

The axillary and cervical lymph nodes are more susceptible to damage than others, and in more rare cases - inguinal, femoral, and submandibular. Sometimes adenitis is localized unusually - in front of the auricle, in the subclavian or supraclavicular region, etc.

Lymph nodes enlarge, reaching 10 cm in diameter. Sometimes they reach 15 cm. When affected, the lymphatic nodes are inactive, dense, sensitive or painful on palpation. Sometimes they fester. Thus, the most important and characteristic sign of benign lymphoreticulosis is enlargement of regional lymph nodes.

Often the disease begins with regional lymphadenitis, intoxication appears later or does not appear at all. And then the only sign of the disease is adenitis. But Most sick children at the peak of the disease develop the following symptoms:

headaches and muscle pain
fever
loss of appetite.

The following symptoms rarely occur:

scarlet-like, morbilliform, erythematous or large nodose rashes on the skin;
intestinal dysfunction.

At the site of infection entering the body, a red papule, sore, pustule, crust or infiltrated, hyperemic and painful scratch appears from cat claws. Long before regional lymphadenitis, the primary affect described above appears. Therefore, at the time of symptoms on the skin, you may hardly notice any changes, or they may be mild.

Felinosis of a typical form follows the “scenario” described above. Atypical form: glandular-ocular, abdominal, anginal, cerebral, pulmonary, etc. Symptoms correspond to the lesion (mesademitis, encephalitis, tonsillitis, pneumonia, conjunctivitis with regional lymphadenitis). Subclinical and erased forms of benign lymphoreticulosis are considered atypical.

Changes in peripheral blood correspond to the stage of the disease. At the beginning, moderate leukocytosis (an increase in the number of leukocytes in the blood) with lymphocytosis and monocytosis is observed. ESR is within normal limits. When suppuration of the lymph nodes begins, leukocytosis ranges from 15 thousand to 25 thousand. Eosinophilia, neutrophilia with a shift to the left, and increased ESR are also observed.

Diagnosis of Benign lymphoreticulosis in children

Felinosis (cat scratch disease) can be diagnosed when a primary affect is detected at the site of cat scratches or bites, regional lymphadenitis with a tendency to suppuration and a long-term torpid (rapid) course, by moderate symptoms of intoxication and changes in the peripheral blood.

When diagnosing, the disease is distinguished from bacterial lymphadenitis, lymphogranulomatosis, tuberculosis of the lymph nodes, and tularemia.

Treatment of Benign lymphoreticulosis in children

Treatment is mainly aimed at eliminating symptoms. If there is suppuration, doctors advise making a puncture of the lymph node or incision. Antibacterial drugs are used (azithromycin, erythromycin, clindamycin) in doses appropriate for age. The course lasts from 5 to 7 days. But the effectiveness of this type of therapy is quite low.

Physiotherapeutic effects are applied to the area of the affected lymph nodes (UHF, diathermy). In severe cases, corticosteroid drugs are used, the course of treatment is short (5 to 7 days). The prognosis is favorable.

Prevention of Benign lymphoreticulosis in children

Lymphoreticulosis benign(synonyms: cat scratch disease, regional nonbacterial lymphadenitis, felinosis, Mollaret-Reci disease) is an acute infectious disease transmitted from cats, characterized by inflammation of regional lymph nodes, fever and general intoxication.

The name of the disease comes from the word Felis (the generic name for cats), since the source of infection is cats - hidden carriers of the causative agent of the disease, which is found in saliva, urine, and on the paws of apparently healthy animals. It is assumed that rodents and birds serve as carriers of the pathogen in nature, but they have no epidemiological significance. Infection occurs through direct contact with infected animals and is realized through skin and mucous membranes, sometimes through contaminated water, objects, food products. Described eye shape diseases when saliva gets on the conjunctiva. The disease occurs in the form isolated cases, more often in children. There is an autumn-winter seasonality; transmission of the pathogen from person to person has not been described.

PATHOGENESIS AND PATHOLOGICAL ANATOMY
The mechanism of development has not been sufficiently studied. From the site of introduction, the pathogen, together with the lymph, is carried into the regional lymph nodes, where it intensively multiplies and releases a toxin. Tissue examination in the lymph nodes reveals overdevelopment of reticular cells with the formation of tuberculosis-like granulomas. Then the pathogen, along with the lymph and bloodstream, penetrates into internal organs where the granulomatous process develops. In regional lymph nodes, the development of granuloma may be accompanied by necrosis and the formation of microabscesses.
Cellular changes are found in regional lymph nodes in the immediate vicinity of the primary affect, and the process may involve either one or a group of lymph nodes. Lymph nodes are enlarged, moderately compacted and fused together. On a section they are dark red in color, homogeneous or with areas of necrosis and melting in accordance with the stage of the pathological process. In the early stages of the disease, overdevelopment of reticular cells predominates with gradual transformation into a granuloma consisting exclusively of epithelial cells. The central part of the granuloma undergoes necrosis, and a microabscess is formed. Subsequently, microabscesses can merge and the entire lymph node, as well as the surrounding tissue, is involved in the process - an inflammatory accumulation is formed with a tendency to melt. Tissue examination often reveals clusters of giant multinucleated cells of the Berezovsky-Sternberg type in foci of inflammation. Cellular changes in benign lymphoreticulosis are not strictly specific; they may resemble changes in tularemia, brucellosis, tuberculosis, and lymphogranulomatosis. In most patients, the dead masses undergo organization followed by resorption or partial sclerosis. Less often, the abscess opens and after removal of the pus, rapid healing occurs. In severe common forms, the granulomatous process is found in the brain (encephalitis), lungs (pneumonia), liver (hepatitis), bones (osteomyelitis), mesentery (adenitis) and other organs.

CLINICAL PICTURE
The incubation period lasts from several days to 42-56 days (on average 1-3 weeks). At the site of an already healed scratch, in more than half of patients, a primary affect is formed - reddish painless swellings on the skin, which often suppurate and heal slowly without forming a scar. The disease begins acutely with moderate fever lasting from 5-7 to 19-20 days, increased fatigue, malaise, headache, anorexia. At this time, a variety of lesions often appear on the skin. allergic rash. In some cases, micropolylymphadenitis (multiple enlargement of lymph nodes), an enlarged spleen, and, less commonly, the liver are detected.
A characteristic feature The disease is regional lymphadenitis. About 2 weeks after the detection of the primary affect, regional lymph nodes enlarge, sometimes significantly (up to 8-10 cm in diameter). When palpated, they are dense, low-painful, and not fused with the surrounding tissues. Most often, the axillary and ulnar lymph nodes are enlarged, less often - the inguinal and cervical ones, which is associated with the entrance gate of infection. Gradually, the process in the lymph nodes resolves - slow sclerosis or their suppuration and opening with the release of greenish pus. Enlargement of regional lymph nodes can be considered the leading clinical sign of benign lymphoreticulosis.
Often the disease begins with regional lymphadenitis, and symptoms of intoxication appear later or are not expressed at all, and then adenitis is practically the only symptom of the disease. However, most patients at the peak of the disease experience fever, headaches, muscle pain, and decreased appetite. In rare cases, intestinal dysfunction and skin rashes of the scarlet-like, measles-like, erythematous or large-nodose type are possible. In most patients, at the site of the entrance gate of infection (usually the arms, face, neck), there is a red swelling; sometimes you can see an ulcer, pustule, crust or an infiltrated, reddish and painful scratch from the cat’s claws. Primary affect appears long before regional lymphadenitis, and therefore, at the peak of clinical manifestations, changes in the skin may be minimal or completely absent.

The described forms of benign lymphoreticulosis are usually classified as typical. Atypical forms are glandular-ocular, anginal, abdominal, pulmonary, cerebral and other rare forms of the disease. Clinical manifestations will correspond to the lesion (conjunctivitis with regional lymphadenitis, pneumonia, tonsillitis, encephalitis, mesadenitis, etc.). They are characterized by a long, sluggish, but benign course. Atypical include erased and subclinical forms of the disease. The development of protracted and recurrent forms of the disease is possible. Known to be severe, but extremely rare complications- encephalitis, encephalomyelitis.

DIAGNOSTICS
Clinical diagnosis is based on identifying primary changes at the site of the entry gate of infection and associated regional lymphadenitis. Important have evidence of contact with cats, scratches, bites or salivation. An increase in the number of eosinophils and increase in ESR. When sowing pus from melted lymph nodes, there is no growth of flora. Laboratory diagnostics based on RSC and intradermal allergy test with related ornithosis or homologous
antigens. Differential diagnosis carried out with common lymphadenitis, tularemia, plague, sodoku, brucellosis, listeriosis, ornithosis, infectious mononucleosis, yersiniosis, tuberculosis, lymphogranulomatosis, lymphomas.

TREATMENT AND PREVENTION
In patients with severe intoxication syndrome and suspected accession bacterial infection use antibiotics wide range actions. In most cases it is prescribed symptomatic treatment. Desensitizing and anti-inflammatory drugs, as well as vitamins, are used. During the period of softening of the lymph node, surgical intervention is indicated - an incision or puncture to remove pus.
For the purpose of prevention, general events provided for diseases transmitted from animals. Bites and scratches are treated disinfectants. Immunoprophylaxis has not been developed, and no measures are taken in the outbreak.