Page 409 - Problem-Based Feline Medicine

20 – THE CAT WITH ENLARGED LYMPH NODES 401

poxvirus infection, discoid lupus erythematosus and Abscesses may spontaneously rupture, at which time
auricular chondritis. systemic signs usually improve.
Regional and generalized lymphadenopathy may be Mild local non-painful lymphadenopathy may occur.
present with flea allergy dermatitis, eosinophilic granu-
loma complex, food hypersensitivity, neoplasia (includ-
Diagnosis
ing cutaneous lymphoma), dermatophytosis, demodicosis,
pemphigus complex, panniculitis, vasculitis, systemic Diagnosis is based on physical examination findings.
lupus erythematosus, drug eruption, erythema multi-
Culture is not routinely performed, but numerous com-
forme/toxic epidermal necrolysis, mechanobullous skin
mon organisms have been isolated.
disease and steatitis.
Lymph node biopsy is rarely warranted but reveals
hyperplasia.
Diagnosis
Wound and lymph node should be examined cytologi-
Work-up of the primary disease will usually identify
cally and cultured if there is painful local lymph-
the reason for the lymphadenopathy. Skin biopsy is
adenopathy.
often required for a definitive diagnosis.
Lymph node biopsy will reveal hyperplasia with or
Differential diagnosis
without metastasis with neoplastic disorders.
Foreign body cellulitis and abscessation.
Differential diagnosis Lymph node abscessation due to juvenile streptococco-
sis or bubonic plague.
Chronic bacterial and other fungal infections.
Differentiation is on the basis of biopsy and culture. Infection with atypical organism that may progress to a
chronic condition.
Treatment Differentiation is on the basis of clinical progression,
cytology and culture.
Treat the primary disease.
Treatment
ACUTE CAT BITE WOUND
CELLULITIS/ABSCESS** Treat the primary disease. See The Pyrexic Cat (page 369).

Classical signs
DIMORPHIC FUNGAL INFECTIONS**
● Acute onset fever, lethargy, inappetence.
● Puncture wounds or abscess(es) from bite. Classical signs
● ± Mild local lymphadenopathy.
● Fever, weight loss, inappetence and
localizing signs of infection.
See main reference on page 368 (The Pyrexic Cat).
See main references on page 25 for details of cryptococ-
cosis (The Cat With Signs of Chronic Nasal Disease),
Clinical signs
page 1095 for sporothricosis (The Cat With Non-Healing
Acute-onset fever, lethargy and inappetence. Wounds), and page 62 for histoplasmosis and blastomy-
cosis (The Cat With Dyspnea or Tachypnea).
The wound area is usually swollen and/or painful;
bites to limbs cause acute lameness.
Clinical signs
Gentle passage of a finger back and forth through the
fur over a painful area will reveal puncture wounds. Non-specific signs are common.