How Dangerous is that Forgotten Cat Scratch?
We’ve all been there – playing with our furry feline friend when suddenly we feel the prick of their claws. Most of the time, a scratch is just a minor nuisance. But what happens if you forget to clean it and an infection sets in? While uncommon, cat scratch disease is a real risk. One study estimates the annual incidence around 4.5 cases per 100,000 people in the U.S. (https://www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information/cat-health-news/cat-scratch-disease-are-you-risk). That may seem low, but with millions of cat owners in the country, it amounts to thousands of cases each year. So what exactly is cat scratch disease and when should you seek medical attention for that forgotten scratch?
Causes of Infection
Cat scratch disease is primarily caused by a bacterial infection of Bartonella henselae, which cats may transmit through scratches, bites, or contact with saliva[1]. Up to 30% of cats may carry this bacteria in their bloodstream, often with no symptoms[2]. The bacteria can then enter the wound from the cat’s claws or mouth and lead to infection.
The scratch itself can also introduce dirt, debris, and microorganisms into the skin, increasing infection risk[3]. Bleeding and damage to the skin from the cat’s claws creates an entry point for bacteria residing on the claws or the surrounding environment. Proper wound care is essential to prevent infectious agents from colonizing the scratch site.
Signs of Infection
If a cat scratch becomes infected, you may notice several signs and symptoms. The most common signs of an infected cat scratch include:
- Redness around the scratch. As the CDC notes, “The infected area may appear swollen and red with round, raised lesions and can have pus” (1).
- Swelling around the scratch site. According to Hopkins Medicine, “If a cat scratch or bite becomes red or swollen…you may have an infection” (2).
- Pus draining from the scratch. The Cleveland Clinic points out that infected scratches can “ooze pus” (3).
- Red streaks extending from the wound. Red streaks from the scratch indicate a spreading infection.
- Fever. An infected cat scratch may also cause flu-like symptoms including fever (2).
Seeking prompt medical care for any of these signs can help treat the infection before it spreads further.
When to Seek Medical Care
If you notice any signs of infection, such as redness, swelling, pus, enlarged lymph nodes, or fever, it’s important to seek medical care within 24 hours for antibiotics. Prompt antibiotic treatment can prevent the infection from becoming serious. According to the CDC, antibiotics are most effective at treating cat scratch disease if started within the first few days of symptom onset (https://www.cdc.gov/healthypets/diseases/cat-scratch.html).
See a doctor right away if the scratch site shows any signs of infection. Some key signs to watch out for include:
- Increasing redness, swelling, warmth at the scratch site
- Pus or yellow/green discharge from the wound
- Red streaks spreading from the wound
- Swollen lymph nodes near the scratch
- Fever over 100.4°F (38°C)
- Flu-like symptoms like headache, fatigue, muscle aches
Even if the scratch looks clean, it’s better to be safe and get examined by a doctor, especially if it was a deep wound. Cat scratches can conceal slow-growing infections that take days to become noticeable. Don’t wait for symptoms to worsen before seeking medical care.
Preventing Infection
There are several key steps you can take to help prevent an infection from developing after a cat scratch:
- Clean the wound immediately with soap and warm water. Scrub gently to remove any dirt or debris. Rinse thoroughly and pat dry with a clean towel (1).
- Apply an antibiotic ointment like Neosporin to the scratch. This can help prevent bacterial contamination of the wound (2).
- Keep the scratch covered with a clean bandage or dressing. Change the bandage daily and check for signs of infection like redness, swelling, warmth, and pus (3).
It’s also important to properly care for your cat to reduce the risk of scratches becoming infected in the first place:
- Use flea control medications as directed by your veterinarian. Fleas can transmit bacteria that cause infection (1).
- Keep cats indoors and avoid scratches/bites. Properly trimming claws can reduce scratching behavior (2).
- Take cats to the veterinarian regularly and keep them up to date on vaccines (3).
Promptly cleaning and caring for cat scratches is key for preventing problematic infections.
Treating an Infected Scratch
If a cat scratch becomes infected, oral antibiotics are usually prescribed to treat the infection. Antibiotics commonly used include azithromycin (Zithromax), according to the American Academy of Family Physicians (https://www.aafp.org/pubs/afp/issues/2011/0115/p152.html). Keeping the wound clean is also important to prevent further infection. This involves gently cleaning the area with mild soap and water and applying an antibiotic ointment. Covering the scratch with a clean bandage that is changed daily is recommended.
In some cases, especially if an abscess has formed, the wound may need drainage. This involves opening and draining the abscess by a healthcare provider. Packing material may be placed in the wound to keep it open and draining. Once drainage is established, antibiotics are continued until the infection clears.
Home Remedies
There are several home remedies that can help treat an infected cat scratch and provide relief from symptoms like pain and inflammation:
Applying a hot compress to the infected scratch can help draw out infection and reduce swelling. Soak a clean washcloth in warm water, ring out excess moisture, and hold it on the infected area for 10-15 minutes a few times per day. The heat helps increase blood flow and white blood cell activity to fight infection.[1]
Taking an Epsom salt bath can also help reduce swelling and pain. Add 1-2 cups of Epsom salts to a warm bath and soak the infected area for 15-20 minutes. The magnesium in the Epsom salts acts as a natural anti-inflammatory.[2]
Applying an over-the-counter antibiotic ointment like Neosporin can help prevent infection and speed healing. Gently clean the area with soap and water, apply a thin layer of ointment, and cover with a bandage. Change the bandage and reapply the ointment daily.[3]
Complications
While most cases of cat scratch disease are relatively mild, some people can develop serious complications that affect the brain, eyes, heart, or other internal organs (CDC, Cleveland Clinic). These rare complications include:
- Septicemia: This serious bloodstream infection can occur when bacteria spreads through the body. Septicemia requires prompt antibiotic treatment and can be life-threatening (Johns Hopkins Medicine).
- Meningitis: Cat scratch disease can sometimes cause an inflammation of the membranes surrounding the brain and spinal cord. Symptoms include fever, headache, and neck stiffness (Johns Hopkins Medicine).
- Arthritis: Some people develop painful joint inflammation after being infected. The knees are most commonly affected (CDC).
- Abscesses: Abscesses are pockets of pus that can form inside the body as a result of the infection. Liver abscesses are a potential complication of cat scratch disease (Cleveland Clinic).
While quite rare, these potentially serious complications demonstrate the importance of promptly cleaning and monitoring any cat scratches or bites. Seeking medical attention at the first signs of infection can help prevent severe complications.
When to Seek Medical Care Again
If an infected cat scratch is not improving or is worsening despite taking antibiotics, it’s important to follow-up with your doctor right away. According to the CDC, “Most healthy people who get cat scratch disease recover fully without antibiotics.” However, in some cases the infection can spread or persist, requiring further medical intervention.
Signs that you may need additional medical care include:
- The infection is spreading beyond the original scratch site
- You develop a fever higher than 101°F
- The sore or redness is worsening or continues to expand in size
- You have red streaks extending from the wound
- Your lymph nodes become very swollen, painful, or tender
According to Johns Hopkins Medicine, “If the infection appears to be worsening after a trial of antibiotics, your doctor may recommend switching to a different antibiotic or prescribing other medications to reduce inflammation.” So be sure to follow up with your doctor if your symptoms don’t improve or get worse while on antibiotics for a cat scratch.
Prevention Tips
There are a few ways to help prevent cat scratches from becoming infected:
Trim your cat’s claws regularly. By keeping their claws short and dull, scratches will be less likely to break the skin and cause infection. UseClippers made specifically for trimming cat claws every 2-3 weeks.
Play therapy for your cat. Providing enough enrichment, toys, and playtime can reduce incidences of scratching humans out of boredom or frustration. Try scheduling at least 2 play sessions per day of at least 15 minutes withinteractive toys like wands and laser pointers.
Avoid handling stray cats. Stray cats are more prone to diseases that can be transmitted by scratches. It’s best not to touch or handle a stray cat unless it’s a medical emergency.
For additional prevention tips, check out this helpful resource from the Humane Society.