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Cat scratch disease: What parents need to know

playing with a kitten

Cat scratch disease is an illness that can occur after being bitten or scratched by a cat or following the bite of a flea. It is caused when the Bartonella henselae bacteria carried by cats or fleas gets under the skin in a human. Cats, and especially kittens, become infected with the cat scratch bacteria from fleas. Cats carrying the bacteria don't get sick and don't need to be treated.

According to a new Center for Disease Control and Prevention (CDC) study, cat scratch disease is highest among people under 65 in the south, and occurs most commonly in kids between 5 and 9 years old.

Most children who get cat scratch disease can recall being around cats, but they rarely recall being scratched or bitten. Here are some common signs and symptoms of the disease:

  • A blister or bump may develop on the skin of your child's arm, leg or head several days after a cat scratch or bite.
  • A few weeks after the scratch or bite, a swollen gland, called a swollen lymph node, may develop in your child's elbow, armpit, groin or neck area, near the location of the injury.
  • The lymph node may be about one to two inches wide, and the skin over it may feel warm and look red.
  • Your child may also have fever, loss of appetite, headache, rash or tiredness.
  • Less commonly, more severe symptoms, such as eye infection, drainage of pus from a lymph node, high fever or infection of the liver, spleen, lungs or nervous system can occur, but even these symptoms usually clear up without serious damage.
  • Cat scratch disease often goes away on its own in two to four months.

Your child's doctor may make a diagnosis of cat scratch disease by checking for signs and symptoms and finding out about recent contact with a cat or kitten. If in doubt, a blood test can be done to look for a reaction to the infection by your child's immune system. This reaction usually shows up in the first 2 months after an infection. In some cases a sample from a lymph node may be looked at under a microscope to help make the diagnosis.

Cat scratch disease is rarely serious and usually goes away on its own without treatment. Once your child has had cat scratch disease, she is unlikely to get it again. Treatment of cat scratch disease may include:

  • Watching and waiting: In most cases skin signs will go away within three weeks, and lymph node swelling will go away within four months.
  • Medications for pain, fever or headache: Acetaminophen or ibuprofen may be given.
  • Pain relief: Apply heat compresses to the affected area.
  • Antibiotics: In more severe cases antibiotics may be given to reduce signs and symptoms.
  • Medical procedure: If a lymph node becomes large, painful or badly infected, a procedure may be done to drain the node or remove it.

If your child gets bitten or scratched by a cat, make sure to wash the area thoroughly with soap and water. Contact your doctor for all cat bites as these also carry a high risk of infection with other bacteria, and antibiotics or a tetanus booster may be necessary. If you see any signs or symptoms of cat scratch disease after contact with a cat, always let your doctor know. If your child is diagnosed with cat scratch disease, let your doctor know if symptoms get worse or don't improve.

Dr. Debra Palazzi, chief of Pediatric Infectious Diseases Clinic