<s>[INST] My 2 year has been tested positive for cat scratch fever. She has a lymph node the size of a golf ball in her armpit. She has been on Zithromax for 2 weeks now and today that started her on Bactrom. Is there anything else that could be causing the lymph node to not go down. [/INST] cat scratch disease is bacterial infection spread by cats. The disease usually  spreads when an infected cat licks a person's open wound, or bites or scratches a person hard enough to break the surface of the skin. And  lymph nodes closest to the original scratch or bite can become swollen, tender, or painful. Generally, cat-scratch disease is not serious. Medical treatment may not be needed. In some cases, treatment with antibiotics is also needed such as azithromycin can be helpful. Other antibiotics may be used, including clarithromycin, rifampin, trimethoprim-sulfamethoxazole, or ciprofloxacin. the size of lymph nodes will regress once antibiotic treatment is done. otherwise follow- up with your attending physician for further evaluation and management. </s>