Treatment for Simple Cat Scratch
For a simple cat scratch, immediate treatment involves thorough washing of the wound with soap and water. 1 This basic first aid measure is the most important step in preventing infection from a cat scratch.
Immediate Care for Cat Scratch
- Wash the wound promptly and thoroughly with soap and water 2
- Clean the area around the wound with an antiseptic solution
- Apply an over-the-counter antibiotic ointment
- Cover with a clean, dry bandage if needed
When to Seek Medical Attention
Most simple cat scratches heal without complications and don't require medical treatment. However, you should seek medical care if:
- The wound appears deep or severely contaminated
- Signs of infection develop (increasing redness, warmth, swelling, pain, or pus)
- You develop fever or swollen lymph nodes
- You are immunocompromised (HIV-infected, on immunosuppressive medications, etc.)
- The scratch is on the face, hands, or near a joint
Special Considerations for High-Risk Individuals
Immunocompromised Patients
Immunocompromised individuals, particularly those with HIV infection and severe immunosuppression, should be especially cautious with cat scratches due to higher risk of developing Bartonella infection 2:
- Consider the risks of cat ownership if severely immunosuppressed
- If keeping cats, adopt animals older than 1 year in good health
- Avoid rough play with cats
- Implement flea control for cats
- Seek prompt medical attention for any cat scratch
When Infection Develops (Cat Scratch Disease)
If infection develops (typically manifesting as tender lymphadenopathy), treatment options include:
- Azithromycin is the first-line treatment for cat scratch disease (CSD), with dosage of 500 mg on day 1 followed by 250 mg for 4 additional days for patients >45 kg 1
- For children <45 kg: 10 mg/kg on day 1 and 5 mg/kg for 4 more days 1
- Alternative antibiotics include erythromycin, doxycycline, ciprofloxacin, or trimethoprim-sulfamethoxazole 3, 4
Prevention of Cat Scratches
- Avoid rough play with cats 2
- Don't allow cats to lick open wounds 1
- Keep cats' nails trimmed
- Implement proper flea control for cats 2
- Supervise children's interactions with cats
Important Caveats
- Most cases of simple cat scratches heal without complications and don't require antibiotic treatment 5
- Cat scratch disease is more common in children but can affect adults as well 5
- Immunocompromised individuals are at higher risk for developing more severe forms of Bartonella infection, including bacillary angiomatosis 6
- Atypical presentations of cat scratch disease can include ocular involvement, encephalopathy, hepatitis, and other systemic manifestations 4