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Last updated: September 14, 2025View editorial policy

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Differential Diagnosis for Pediatric Patient Scratched by Cat

Single Most Likely Diagnosis

  • Cat Scratch Disease (Bartonellosis): This is the most common and likely diagnosis, caused by the bacterium Bartonella henselae, which is transmitted through cat scratches or bites. It typically presents with a papule or pustule at the site of the scratch, followed by regional lymphadenopathy.

Other Likely Diagnoses

  • Cellulitis: A bacterial skin infection that can occur after a cat scratch, characterized by redness, swelling, warmth, and tenderness of the skin.
  • Abscess: A collection of pus that can form at the site of the scratch, often requiring drainage.
  • Staphylococcal or Streptococcal Infections: Bacterial infections caused by Staphylococcus or Streptococcus species, which can lead to conditions like impetigo or erysipelas.

Do Not Miss Diagnoses

  • Rabies: Although rare, rabies is a deadly viral disease that can be transmitted through the scratch of an infected animal, making prompt recognition and treatment crucial.
  • Tetanus: A bacterial infection caused by Clostridium tetani, which can enter the body through wounds, including scratches. It's essential to ensure the child's tetanus vaccination is up to date.
  • Pasteurella multocida Infection: A bacterial infection that can cause severe disease, including sepsis, especially in individuals with compromised immune systems.

Rare Diagnoses

  • Capnocytophaga canimorsus Infection: A bacterial infection that can be transmitted through animal bites or scratches, more commonly associated with dog bites but can occur with cat scratches, especially in immunocompromised individuals.
  • Erysipeloid: A rare bacterial infection caused by Erysipelothrix rhusiopathiae, which can be transmitted through contact with infected animals, including cats.
  • Actinomycosis: A rare chronic bacterial infection that can affect the skin and other tissues, potentially acquired through animal scratches or bites.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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