What to do if a baby is scratched by a cat?

From the Guidelines

If your baby is scratched by a cat, immediately clean the wound with mild soap and warm water for at least 5 minutes to remove bacteria, as this is crucial in preventing infections such as cat scratch disease and rabies 1. The most important step in managing a cat scratch is to ensure the wound is clean. This involves washing the area with mild soap and warm water. It's also essential to pat the area dry with a clean towel and apply an antiseptic like hydrogen peroxide or povidone-iodine (Betadine) to further reduce the risk of infection. Some key points to consider when a baby is scratched by a cat include:

• Monitoring the wound for signs of infection such as increasing redness, swelling, warmth, pus, or if your baby develops a fever.
• Seeking medical attention if the scratch is deep, won't stop bleeding, shows signs of infection, or if your baby develops fever, swollen lymph nodes, or seems unusually irritable.
• Considering antimicrobial treatment, such as azithromycin, for cat scratch disease, with dosing protocols as follows: 500 mg on day 1 followed by 250 mg for 4 additional days for patients over 45 kg, and 10 mg/kg on day 1 and 5 mg/kg for 4 more days for patients under 45 kg 1.
• Using pain relief such as acetaminophen (Tylenol) according to the age-appropriate dosing instructions, but avoiding aspirin in children. Prevention is also crucial, and this includes supervising interactions between cats and babies, keeping cats' nails trimmed, and teaching older children how to properly handle pets. Given the potential for cat scratch disease, which is caused by the bacteria Bartonella henselae, it's essential to be vigilant for symptoms such as lymphadenopathy, which can develop about 3 weeks after inoculation, and to seek medical attention if there are any concerns 1.

From the Research

Immediate Response to Cat Scratch

• If a baby is scratched by a cat, it is essential to clean the wound immediately with soap and water to reduce the risk of infection 2.
• The wound should be monitored for signs of infection, such as redness, swelling, or pus, and medical attention should be sought if any of these symptoms occur.

Risk of Cat-Scratch Disease

• Cat-scratch disease (CSD) is a bacterial infection caused by Bartonella henselae, which can be transmitted to humans through cat scratches or bites 3, 4.
• The disease typically causes lymphadenitis, but can also lead to more severe complications, such as Parinaud oculoglandular syndrome, encephalopathy, or hepatosplenic infection 3, 4.

Treatment of Cat-Scratch Disease

• In most cases, CSD is self-limiting and does not require antibiotic treatment 4, 5.
• However, for patients with severe disease or immunocompromised individuals, antibiotic therapy may be necessary, and drugs such as rifampin, ciprofloxacin, gentamicin, or azithromycin have shown efficacy in treating CSD 4, 5.
• It is essential to note that incision and drainage of the affected lymph node should not be performed, as this can lead to further complications 3.

Prevention of Infection

• To reduce the risk of infection, it is crucial to practice good hygiene, such as washing hands after handling cats or their litter boxes 2.
• Additionally, keeping cats indoors and avoiding rough play with cats can help minimize the risk of scratches or bites.