Cat scratch disease is a bacterial infection that a person can get after being scratched, licked, or bitten
by a cat or kitten.
In the United States, most cases happen in the fall and winter and usually affect
kids, probably because they're more likely to play with cats and be bitten or scratched.
Bartonella henselae, the bacteria
that cause this disease, live in infected cats' saliva but don't make the animals
sick. In fact, kittens or cats may carry the bacteria for months. Fleas spread
the bacteria between cats.
Signs & Symptoms
The first sign of this infection is a blister or a small bump
that develops several days after the scratch or bite and may resemble a bug
bite. This blister or bump is called an inoculation lesion (a wound at the site
where the bacteria enter the body). Lesions are most commonly found on the arms and
hands, head, or scalp and usually are not painful.
Within a couple of weeks of a scratch or bite, one or more lymph nodes close to
the area of the inoculation lesion will swell and become tender. (Lymph nodes are
round or oval-shaped organs of the immune system that are often called glands.) For
example, if the inoculation lesion is on the arm, the lymph nodes in the elbow or
armpit will swell.
These swollen lymph nodes appear most often in the underarm or
neck areas, although if the inoculation lesion is on the leg, the nodes in the groin
will be affected. They range in size from about ½ inch to 2 inches in diameter and
may be surrounded by a larger area of swelling under the skin. The skin over these
swollen lymph nodes can become warm and red.
In most kids, swollen lymph nodes are the main symptom of the disease, and the
illness often is mild. If kids have other general symptoms, they might include fever (usually less than 101°F
or 38.3°C ), fatigue, loss of appetite, headache,
rash, sore throat,
and an overall ill feeling.
The swollen lymph nodes usually disappear within 2 to 4 months, although sometimes
can last much longer. In rare cases, a person might develop other symptoms,
including infections of the liver, spleen, bones,
joints, or lungs, or a lingering
high fever without other symptoms.
Diagnosis and Treatment
Doctors usually diagnose cat scratch disease based on a child's history of exposure
to a cat or kitten and a physical examination. During the exam, the doctor will look
for signs of a cat scratch or bite and swollen lymph nodes.
In some cases, doctors use laboratory tests to help make the diagnosis, including:
blood tests and cultures to rule out other causes of swollen lymph nodes
a blood test that is positive for cat scratch disease
Most cases do not need any special treatment. Antibiotics are sometimes used to
treat a severe form of the disease. If your doctor has prescribed antibiotics, give
them to your child on schedule and for as many days as prescribed.
Kids with cat scratch disease don't need to be isolated from other family members.
Bed rest is not necessary, but can help if a child tires easily. If your child feels
like playing, encourage quiet play while being careful to avoid injuring swollen lymph
nodes. To ease sore nodes, give your child nonprescription medicines like acetaminophen
Cat scratch disease is not contagious from person to person. The bacteria are spread
by the scratch or bite of an infected animal, most often a kitten. They also can spread
if the animal's saliva (spit) comes in contact with a person's eye or through broken
skin. Sometimes multiple cases happen in the same family, usually through contact
with the same infected animal.
Having one episode of cat scratch disease usually makes people immune for the rest
of their lives.
If you're concerned about cat scratch disease, you do not need to get rid of the
family pet. The illness is not common and usually is
mild, and a few steps can help limit your kids' chances of contracting it.
Teach kids to avoid stray or unfamiliar cats to reduce their exposure to sources
of the bacteria. To lower the risk of getting the disease from a family pet or familiar
cat, kids should avoid rough play to prevent being scratched or bitten. Have
your family members wash
their hands after handling or playing with a cat.
If your child is scratched by a pet, wash the injured area well with soap and water.
Keeping the house and your pet free of fleas will reduce the risk that your cat could
become infected with the bacteria in the first place.
If you suspect that someone caught cat scratch disease from your family pet, don't
worry that your cat will have to be euthanized (put to sleep). Talk with your veterinarian
about how to handle the problem.
When to Call the Doctor
Call the doctor whenever your child has swollen or painful lymph nodes in any area
of the body. And always call your doctor if a child is bitten by an animal, especially
the bite or scratch was from a cat and the wound does not seem to be healing
an area of redness around the wound keeps expanding
the child develops a fever that lasts for a few days after receiving the scratch
If your child has already been diagnosed with cat scratch disease, call the doctor
if your child has a high fever, lots of pain in a lymph node, seems very sick, or
develops new symptoms.