Cat Scratch Disease in Children

Cat scratch disease is an illness that can occur after being bitten or scratched by a cat. It is caused when the Bartonella henselae bacteria carried by cats gets under the skin in a human. Cats, and especially kittens, become infected with the cat scratch bacteria from fleas. But, fleas probably do not spread the bacteria to humans. Cats that are carrying the bacteria don't get sick and don't need to be treated. Cat scratch disease often goes away on its own in 2 to 4 months.

Cat scratch disease is most common in people younger than 20. Humans can't spread catch scratch disease to other humans. 

Note: Cat scratch disease should not be confused with toxoplasmosis, which is a more serious disease, especially for pregnant women. Toxoplasmosis can be spread from cat feces in litter boxes.

What are the symptoms of cat scratch disease?

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 mild fever, loss of appetite, headache, rash, or tiredness.

In rare cases, 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.

How is cat scratch disease diagnosed?

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 two 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.

How is cat scratch disease treated?

Cat scratch disease is rarely serious and usually goes away on its own in 2 to 4 months without treatment. Once your child has had cat scratch disease, he or 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. Do not give your child or teen aspirin because its use in children has been linked to Reye's syndrome, a rare but potentially life-threatening condition.

  • 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 are very high risk for a different type of infection. 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. 

How can I prevent cat scratch disease?

To prevent cat scratch disease,

  • Keep your cat free of fleas. 

  • Prevent kittens or cats from licking an open wound.

  • Wash the area thoroughly with running water and soap right away after a bite or scratch.

  • Tell your children to avoid stray cats.

  • Tell children not to play roughly with any cats or kittens and to stop petting them if they see "airplane ears"–flattened ears on a cat are often a warning sign that they want to be left alone.

  • Make sure children wash their hands after playing with a cat.

Unless your child has another illness that weakens his or her immune defense system (such as cancer, HIV, or an organ transplant), these precautions should be enough to keep your child safe.