From the Guidelines
Yes, cat scratch fever can occur without a cat scratch, as the bacterium Bartonella henselae can enter the human body through any break in the skin, including cat bites, licks on broken skin, or flea bites that have been in contact with infected cats. The infection typically causes symptoms such as swollen lymph nodes near the site of infection, fever, fatigue, and sometimes a pustule at the entry point 1.
Key Points to Consider
- The disease is commonly transmitted through cat scratches, but other modes of transmission are possible, including cat bites and licks on broken skin 1.
- The bacterium Bartonella henselae lives in the saliva of cats and can enter the human body through any break in the skin 1.
- Treatment usually involves antibiotics such as azithromycin, with a recommended dose of 500mg on day 1, then 250mg daily for 4 more days for patients weighing ≥45.5 kg 1.
- Prevention measures include washing any cat-related wounds promptly with soap and water, avoiding rough play with cats, and controlling fleas on pets 1.
Recommendations for Treatment and Prevention
- Azithromycin is recommended for cat scratch disease, with a dosing protocol of 500mg on day 1, followed by 250mg for 4 additional days for patients >45 kg 1.
- Patients should avoid contact with flea feces and any cat-associated wound should be washed promptly 1.
- Care of cats should include a comprehensive, ongoing flea-control program under the supervision of a veterinarian 1.
From the Research
Cat Scratch Fever Transmission
- Cat scratch fever, also known as cat-scratch disease, is typically transmitted through a cat scratch or bite, but it can also be transmitted through other means 2, 3, 4.
- The bacterium Bartonella henselae, which causes cat scratch disease, can be transmitted to humans through the bite or scratch of an infected cat, as well as through contact with infected cat fleas or other arthropod vectors 2, 3, 4.
- In rare cases, cat scratch disease can also be transmitted through blood transfusion 3.
Alternative Transmission Methods
- While a cat scratch is the most common mode of transmission, it is possible for cat scratch fever to occur without a cat scratch 4.
- Other animals, such as dogs, guinea pigs, and rabbits, can also carry Bartonella henselae and potentially transmit it to humans 5, 4.
- Arthropod vectors like fleas, ticks, and biting flies can also play a role in transmitting the disease to humans 4.
Diagnosis and Treatment
- Diagnosis of cat scratch disease is typically based on a history of exposure to cats and a serologic test with high titers of immunoglobulin G antibody to B. henselae 2, 5.
- Most cases of cat scratch disease are self-limited and do not require antibiotic treatment, but azithromycin has been shown to speed recovery in some cases 2, 5.