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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.