Medical knowledge, Patient Education
Cat-Scratch Disease, Pediatric
Cat-Scratch Disease, Pediatric
Elsevier Patient Education © 2023 Elsevier Inc..
Last revised: October 6, 2023.
Cat-scratch disease is a bacterial infection that is spread to humans through a bite or scratch from an infected cat. The infection can also be spread by having contact with an infected cat and then touching your eyes or mouth. It is sometimes called cat-scratch fever. The infection does not spread from person to person (is not contagious).
In most cases, the infection is mild and clears up without treatment. However, a more severe infection can develop in very young children or in children who have other illnesses or problems that weaken the body’s disease-fighting system (immune system).
What are the causes?
This condition is caused by bacteria called Bartonella henselae. These bacteria are carried by fleas. Cats get infected from flea bites or flea droppings. The bacteria may be present in the mouth or on the claws of cats or kittens, especially those that are younger than 1 year old. Cats do not look or act sick when they have this infection.
What increases the risk?
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Lives with or interacts with a cat.
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Has a weakened immune system. Your child’s immune system may be weakened if he or she:
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Has a certain condition like cancer, HIV, or AIDS.
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Received a donated organ (transplant).
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What are the signs or symptoms?
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A bite or scratch that does not heal.
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A red bump near the wound. The bump may be red, warm, and tender to the touch.
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Swollen, tender glands (lymph nodes) in the neck or under the arm.
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Fever.
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Rash.
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Joint pain.
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Headache.
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Low energy (listlessness).
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Loss of appetite.
How is this diagnosed?
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A culture test. This involves testing a sample of fluid or pus from your child’s wound.
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Blood tests.
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A lymph node biopsy. This involves removing and testing a tissue sample from a swollen lymph node.
How is this treated?
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Your child’s immune system is weakened.
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Your child’s symptoms cause discomfort.
If your child has a painful, swollen lymph node, it may be drained with a needle. This is rare.
Follow these instructions at home:
Medicines
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Give your child over-the-counter and prescription medicines only as told by your child’s health care provider.
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Do not give your child aspirin because of the association with Reye’s syndrome.
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If your child was prescribed an antibiotic medicine, give it as told by his or her health care provider. Do not stop giving the antibiotic even if your child starts to feel better.
General instructions
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Have your child return to his or her normal activities as told by his or her health care provider. Ask your child’s health care provider what activities are safe for your child.
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Apply warm compresses to the area as told your child’s health care provider.
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Check your child’s wound or swollen lymph node areas every day for signs of infection. Check for:
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Redness, swelling, or pain.
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Fluid or blood.
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Warmth.
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Pus or a bad smell.
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Keep all follow-up visits. This is important.
How is this prevented?
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Do not allow your child to play roughly with cats or to take food away from a cat.
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Have your child wash his or her hands well after having contact with a cat.
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If your child gets scratched or bitten, wash the area as soon as possible with warm water and soap.
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Do not let a cat lick your child’s skin if there are any cuts, sores, or scratches.
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Do not allow your child to pick up or play with a stray cat.
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If your child has an indoor cat:
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Do not let the cat outside. Having contact with stray cats may make the cat more likely to have contact with the bacteria.
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Trim the cat’s nails.
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Check your cat for fleas. Ask your veterinarian which flea and tick repellent is safe to use for your child and your cat.
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Contact a health care provider if:
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Your child has signs of infection in the wound or lymph nodes, such as:
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Redness, swelling, or pain.
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Fluid or blood.
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Warmth.
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Pus or bad smell.
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Your child has a fever.
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Your child’s symptoms get worse or do not get better.
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Your child has pain in the bones.
Get help right away if:
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Your child who is younger than 3 months has a temperature of 100.4°F (38°C) or higher.
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Your child develops pain in the abdomen.
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Your child’s skin rash spreads.
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Your child feels dizzy or faints.
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Your child develops inflammation of the eye or vision problems.
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Your child develops a stiff neck.
These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.).
Summary
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Cat-scratch disease is an infection caused by bacteria that may be present in the mouth or on the claws of cats or kittens, especially those that are younger than 1 year old.
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The bacteria may spread to your child if he or she has contact with, or is bitten or scratched by, an infected cat or kitten.
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The first sign may be a bite or scratch that does not heal. There may be a bump on the skin that is red, warm, and tender to touch. Other signs and symptoms include swollen lymph nodes and flu-like symptoms.
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In most cases, your child’s health care provider will diagnose cat-scratch disease based on a history of a cat bite or scratch and a physical exam.
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The infection usually clears up without treatment, but some children may need antibiotic medicine.
This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.
