Cat-scratch disease often not treated

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DEAR DR. DONOHUE: We caved in to our 5-year-old daughter’s Oscar-worthy pleas for a kitten. Naturally, she got some scratches, which she and we ignored. However, she also got a lump under her right arm, and we took her to the pediatrician, who said it was cat-scratch disease. He did not prescribe any medicine. The lump is still there. Should she have gotten medicine? – M.O.

ANSWER: Cat-scratch disease was first recognized more than 70 years ago, but the germ causing it was not discovered until 20 years ago. The germ is transmitted through cat scratches, most often through kitten scratches.

After a scratch from an infected cat, a small red bump appears at the scratch site in a week to 10 days. Most people pay no attention to it. One to four weeks later, a lymph node swells, and if it’s the arm or hand that has been scratched, the involved node pops up under the arm. The node (lump) can be tender. In addition, some – and this can happen in both children and adults – will have a fever and complain of sore muscles.

In a small number of infected people, serious complications can develop, like a brain infection. For most, however, the enlarged node or nodes are the only sign of infection. They stay large for months and months, but their tenderness disappears.

Antibiotic treatment isn’t indicated in the majority of cases. In the very sick or in those whose immune systems are not up to par, antibiotics, such as azithromycin or doxycycline, have been used.

You don’t have to get rid of the cat. People almost never have a second round of cat-scratch disease.

DEAR DR. DONOHUE: My son is 9 months old. He has started to bang his head against the side rails of his crib. My husband cringes and almost gets hysterical when he does this. What’s making the baby do this, and how can we stop him? – N.P.

ANSWER: Most babies, if they start head-banging, usually do so between the ages of 5 months and 11 months. Generally, it lasts for a couple of months. Just about all stop by 2½ to 3 years of age.

There are many explanations why infants head-bang, but no one is absolutely sure of the cause. It must give the baby some satisfaction and relief from anxiety.

If the doctor has examined your baby and found nothing wrong with him or his development, you and your husband don’t have to worry. Padding the sides of the crib protects his head and spares your nerves. Some advise picking up the child when he starts the banging. Give your baby even more attention than he probably is already getting.

DEAR DR. DONOHUE: I take thyroid medicine on a daily basis. My thyroid gland doesn’t make enough thyroid hormone. I read a magazine article that said kelp is a more natural remedy for thyroid illnesses than thyroid medicines. I would like to give it a try. Would it hurt to do so? – J.M.

ANSWER: Don’t even think about making such a switch.

Kelp is seaweed, and it contains iodine. Thyroid hormone has iodine in it. However, that’s not saying that everything with iodine in it is a good replacement for thyroid hormone.

You’d be putting yourself in harm’s way by stopping your hormone and taking kelp.

DEAR DR. DONOHUE: I am so weary of reading and hearing about diets and about people making fortunes with diet books and diet pills.

When I was a nurse years ago, an elderly, great doctor gave advice to his overweight patients. He would tell them they could eat a little bit of everything, but the emphasis was on “a little bit.” And he told them to recognize when to push away from to the table. Too simple, I suppose, to appeal to the modern mind. – E.H.

ANSWER: The weight-loss industry could learn not to like you.

His advice is sound and applicable to many people. There are some, however, who, no matter how little they eat and how long they exercise, still find it impossible to lose weight. They are the few who deserve special attention.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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