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Cat-scratch disease CSD is mostly contracted by children and young adults. To our knowledge, CSD in elderly patients has never been characterized, and it may be underrecognized in this age group. The study population included all patients with CSD diagnosed at our reference laboratory during — There were immunocompetent patients with CSD included in this study. Lymphadenopathy was less common in elderly patients than in nonelderly patients Atypical CSD was more common in elderly patients than in nonelderly patients CSD affects elderly persons as well as nonelderly persons, but clinical features differ between the patient groups.

Atypical CSD, including endocarditis, is more frequent in elderly than in nonelderly patients. Conversely, lymphadenitis, the hallmark of typical CSD, is often absent in elderly patients. Lack of awareness among clinicians may delay the diagnosis of CSD in elderly persons and result in unnecessary and often invasive diagnostic procedures. Cat-scratch disease CSD is an illness caused by infection with the intracellular bacterium Bartonella henselae.

Endocarditis is an additional severe form of B. The diagnosis of CSD, particularly in atypical cases, can easily be overlooked, unless a history of cat exposure or suggestive findings of histopathologic examination prompt specific testing for B. The diagnosis of CSD in an elderly patient may be especially problematic for several reasons. First, CSD is a disease of the young. Thus, clinicians caring for elderly patients may be inclined to disregard the possibility of CSD, even in a patient with a typical clinical presentation.

Second, although large case studies have included elderly patients i. Of particular importance, the frequency of atypical manifestations of CSD, which can be associated with considerable morbidity and even mortality, has never been determined in elderly persons.