Most cat scratches are small wounds that heal without trouble once they are cleaned. But a cat’s claws can carry bacteria into the skin, which is why a scratch isn’t quite the same as an ordinary cut.1Centers for Disease Control and Prevention. About Cat Scratch Disease2PubMed. Pasteurella multocida–the major cause of hand infections following domestic animal bites Kittens and stray cats carry more risk than an adult pet cat that is kept free of fleas.3Centers for Disease Control and Prevention. About Cat Scratch Disease
What to Do Right After a Cat Scratch
Start by rinsing the scratch under running water to flush out as much bacteria as possible.4Cleveland Clinic. What To Do for a Cat Bite or Scratch Be gentle about it, because scrubbing hard can damage the tissue and make the wound worse.5Cleveland Clinic. What To Do for a Cat Bite or Scratch Then wash the area with soap and water.6Cleveland Clinic. What To Do for a Cat Bite or Scratch Pat it dry and cover a deeper scratch with a clean bandage. Avoid letting the cat lick the scratch or any open wound, since its saliva can carry germs into broken skin.7PubMed Central. Cat scratch disease: What to do with the cat?8PubMed Central. Feline rabies. ABCD guidelines on prevention and management
Hydrogen peroxide or alcohol isn’t needed and can irritate healthy tissue. Sealing a dirty scratch under a tight bandage without washing it first traps bacteria against the skin, and squeezing or picking at the scratch can spread them further. Scratches on the hand or near a joint deserve closer watching, because infections there can spread quickly.
A minor scratch usually looks like a thin red line that is a little sore for a day or two. A bit of pinkness right at the edges isn’t a sign of infection by itself. The change to watch for is redness that widens, throbs, or warms up after the first day. Jot down the date and which cat scratched you, since some problems appear weeks later.
Some scratches shouldn’t wait for home care. Get seen the same day if the scratch is deep, gaping, or won’t stop bleeding. The same goes if the cat was a stray or behaving strangely, which raises rabies questions, or if you have a weakened immune system from illness or medicines. A scratch on the face or near the eye also needs a prompt look.
Fast Skin Infections That Show Up Within Two Days
A bacterium called Pasteurella multocida is a common cause of infection after cat bites and scratches, more so with cats than dogs.9PubMed. Pasteurella multocida–the major cause of hand infections following domestic animal bites It tends to show up fast, usually between 3 and 48 hours after the injury.10MD Searchlight. Pasteurella Multocida The typical result is a spreading skin infection around the wound.11PubMed. Pasteurella multocida–the major cause of hand infections following domestic animal bites Swelling, redness, and tenderness at the scratch are the usual signs.12MD Searchlight. Pasteurella Multocida
Normal healing keeps a thin red line. A spreading infection looks different: the red area grows outward over hours, the skin feels hot and tight, and the pain gets sharper instead of duller. Pus or fluid oozing from the scratch is another sign. Red streaks running up the arm, or a fever, mean the infection is spreading and needs urgent care.
A clean-looking scratch can still turn into one of these. Pasteurella lives in the mouths of many healthy cats, so a cat can carry it with no sign of illness, and the claws can pick it up when the cat licks or grooms its paws. Even a shallow break in the skin can let bacteria in.
Hands get special attention because tendons and joints sit close to the skin there, giving bacteria a path to travel. Swelling that makes fingers stiff or hard to bend needs same-day care. This kind of infection usually needs prescription antibiotics rather than waiting it out.
Cat Scratch Disease and Its Delayed Symptoms
Cat scratch disease (CSD) is caused by Bartonella henselae bacteria.13Centers for Disease Control and Prevention. About Cat Scratch Disease Cat fleas spread the bacteria between cats and leave it in their droppings.14PubMed Central. Uncovering the truth about cat-scratch disease A person gets infected when a scratch is contaminated with flea droppings caught in the cat’s claws.15Centers for Disease Control and Prevention. About Cat Scratch Disease16PubMed Central. Cat scratch disease: What to do with the cat? The bacteria can survive about 3 days in flea droppings.17PubMed Central. Uncovering the truth about cat-scratch disease Scratching your own flea bite can rub in flea droppings the same way.18PubMed Central. Cat scratch disease: What to do with the cat?
The symptoms unfold over weeks. A small raised bump or blister often appears at the scratch about 3 to 10 days after it.19PubMed Central. Cat Scratch Disease – The Inconspicuous Cause of Cervical Lymphadenopathy20Centers for Disease Control and Prevention. Cat Scratch Disease: Risks, Symptoms, and Treatment It is often small, pink or red, and can look like a pimple, an insect bite, or a blister, so many people ignore it. It usually isn’t very painful and may crust over or leave a short-lived mark as it fades.
Then the lymph nodes, the small glands that swell when fighting infection, become enlarged and tender 1 to 3 weeks after cat contact.21Centers for Disease Control and Prevention. Cat Scratch Disease: Risks, Symptoms, and Treatment A low-grade fever can come with them.22Centers for Disease Control and Prevention. Cat Scratch Disease: Risks, Symptoms, and Treatment The swollen glands are usually the ones nearest the scratch, such as in the armpit after a hand or arm scratch, or the neck after a face scratch.23PubMed Central. Cat Scratch Disease – The Inconspicuous Cause of Cervical Lymphadenopathy Often it’s one firm, tender lump on the same side as the scratch. It can be larger than a grape and stay swollen for weeks. A lump that keeps growing, turns very red, or drains needs a doctor’s look.
Many people feel mildly unwell rather than seriously sick, with fatigue, a low fever, and sometimes a headache or loss of appetite. Many people have also forgotten the scratch by the time the glands swell, so mentioning the cat to a doctor matters.
Doctors usually start by asking about cats, kittens, and fleas, which is often the biggest clue. A blood test can look for antibodies to the bacteria, and when it’s unclear, a lab test on fluid from the lump can find the bacteria’s genetic material. Results aren’t always clear-cut, so diagnosis often combines the story and the tests.
Does Cat Scratch Disease Need Treatment
In people with healthy immune systems, cat scratch disease usually clears up on its own.24PubMed Central. Cat Scratch Disease – The Inconspicuous Cause of Cervical Lymphadenopathy25CDC. Clinical Overview of Cat Scratch Disease Antibiotics may shorten how long symptoms last.26CDC. Clinical Overview of Cat Scratch Disease A short course of azithromycin shrank swollen glands faster than no treatment in one small study, though people’s overall recovery was no different with or without the drug.27CDC. Clinical Overview of Cat Scratch Disease Whether to treat a mild case is a choice to talk through with your doctor.
Without treatment, the bump at the scratch fades first. The swollen gland can take weeks to a few months to shrink. Pain relievers and warm compresses can ease tenderness. See your doctor again if fever rises or the lump becomes very painful.
Occasionally a gland fills with pus and becomes very painful and tense, and a doctor may drain it with a needle to relieve the pressure. That is done by a clinician and shouldn’t be tried at home, since squeezing or cutting the lump can cause further infection.
Severe cases and people with weakened immune systems should be treated with antibiotics.28CDC. Clinical Overview of Cat Scratch Disease Infections that spread to the eye, liver, or heart need longer treatment, often with more than one antibiotic.29CDC. Clinical Overview of Cat Scratch Disease Many common antibiotics work poorly against this infection, so doctors choose specific ones.30PubMed. Antibiotic therapy for cat-scratch disease: clinical study of therapeutic outcome in 268 patients and a review of the literature
Who Is at Higher Risk of Serious Problems
Most people recover fully, but in people with weakened immune systems the illness can be much worse.31PubMed. Cat-scratch disease in an immunocompromised host In people with HIV or an organ transplant, the bacteria can spread to internal organs like the liver and spleen.32PubMed. Visceral bacillary epithelioid angiomatosis: possible manifestations of disseminated cat scratch disease in the immunocompromised host: a report of two cases If you have HIV, a transplant, cancer treatment, or take immune-lowering medicines, tell a doctor about any cat scratch that seems infected.
Instead of one swollen gland, a person might have weeks of fever, night sweats, weight loss, and fatigue. Some people with weakened immunity develop growths in the skin or elsewhere in the body, which a doctor should assess. Because these signs are vague, anyone with a weak immune system who has had cat contact should mention it when they have unexplained fever.
The eye is the most common place for unusual problems. About 4% of people with cat scratch disease develop an eye form with a red, irritated eye and swollen glands near the ear.33PubMed Central. Bartonella Neuroretinitis: There Is More to Cat Scratch Disease than Meets the Eye Rarely, the infection can inflame the back of the eye and blur vision.34PubMed. Bartonella henselae neuroretinitis in cat scratch disease. Diagnosis, management, and sequelae New blurry vision or a red eye after cat contact needs prompt medical care.
Children and new kitten owners get cat scratch disease most. Kids play roughly with kittens and get scratched often, and young kittens are the most likely carriers. Cases are also more common in fall and winter, when fleas are more numerous.
Rabies, Tetanus, and Fungal Infections
Rabies virus is in an infected cat’s saliva and can pass through a bite or a scratch.35PubMed Central. Feline rabies. ABCD guidelines on prevention and management36PubMed Central. Paralytic rabies following cat scratch and intra-dermal anti-rabies vaccination The virus can be in saliva some days before the cat looks sick.37PubMed Central. Feline rabies. ABCD guidelines on prevention and management A scratch from a stray, feral, or unvaccinated cat should be discussed with a doctor the same day. If it was a stray, report it to local animal control. Rabies shots after exposure work only if started before symptoms begin. Pet cats kept indoors with current shots pose very low rabies risk.
If the cat is a pet that can be kept at home and watched, a doctor or health department may use observation to decide how worried to be. A cat that stays healthy for 10 days after the scratch is considered very unlikely to have been shedding rabies virus when it scratched you. If it becomes sick or dies in that time, the cat needs testing and you need to start shots promptly.
Treatment after exposure is a series of vaccine doses over about two weeks, and in some cases a one-time antibody injection given near the wound. It is routine medical care, not a last resort, and the usual injections go in the upper arm like other vaccines.
Tetanus and fungus are less common risks. Tetanus has been reported after repeated cat scratches and bites in one case.38PubMed. Tetanus after cat scratch and bites in a previously immunized patient If your last tetanus shot was over 10 years ago, or 5 for a dirty wound, ask about a booster. In parts of Brazil, a fungal skin infection called sporotrichosis spreads mainly through scratches from infected cats.39PubMed Central. Clinical features, fungal load, coinfections, histological skin changes, and itraconazole treatment response of cats with sporotrichosis caused by Sporothrix brasiliensis
How to Lower the Risk From Your Own Cat
Fleas are the main way the bacteria spread among cats.40PubMed Central. Uncovering the truth about cat-scratch disease Year-round flea prevention for your cat lowers your risk.41Centers for Disease Control and Prevention. About Cat Scratch Disease42The Gentle Vet. What Is Cat Scratch Fever?
Veterinarians can prescribe or recommend monthly flea treatments for cats, which kill fleas before they build up. Over-the-counter products vary, and some made for dogs are dangerous to cats, so check with a vet before using any. Indoor-only cats can still get fleas from dogs or from people’s clothing, so they need prevention too.
Treating the home matters as well. Flea eggs and larvae live in carpets, bedding, and cracks in floors, so treating only the cat leaves a source of re-infestation. Washing the cat’s bedding in hot water and vacuuming regularly removes many eggs and flea droppings. If fleas keep returning, a vet can advise on whether the home needs treatment.
A few habits cut down on scratches themselves. Trim claws regularly or offer a scratching post. Play with toys rather than hands and feet. Teach children to handle kittens gently and to wash their hands afterward, and avoid petting or handling stray cats.
You don’t need to get rid of the cat. Doctors do not recommend giving up a cat after cat scratch disease, and treating fleas is the useful step. People with weak immune systems may want to choose an adult cat over a kitten.