0521779407-C01 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:53
286 Cardiac Tumors Cat Scratch Disease➣should carry out operation promptly after diagnosis
➣complications – dislodgement of tumor fragments resulting in
peripheral emboli or dispersion of micrometastasis is major risk
■Malignant Tumors
➣surgery is Rx of choice if feasible
➣partial resection
➣chemotherapy
➣radiation therapy
■Metastatic tumors
➣no definitive Rx of choice
➣chemotherapy
➣radiation therapy
➣surgery
➣if recurrent pericardial effusion occurs, pericardial window or
percardiectomyfollow-up
■Repeat TTE to exclude recurrence
complications and prognosis
Prognosis
■Benign tumors – surgery generally curative with perioperative mor-
tality of about 5%
■Malignant tumors – most pts die within 1 year of diagnosis
■Metastatic tumors – ranges from 6 months for pts with solid tumors
to greater than 15 months for pts with lymphomaCatScratch Disease...................................
RICHARD A. JACOBS, MD, PhD
history & physical
History
■caused by Bartonella henselae, a slow-growing, fastidious, aerobic
gram-negative rod
■up to 55% of cats have serologic evidence of infection with B. hense-
lae and 40% of randomly sampled healthy cats are bacteremic with
the organism (prevalence of seropositivity and bacteremia higher in
kittens and feral cats)
■exposure to cats almost universal