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Last updated: September 17, 2025View editorial policy

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Differential Diagnosis for Dog Scratch

  • Single most likely diagnosis:
    • Cat-scratch disease (Bartonellosis): This is the most likely diagnosis because the bacteria Bartonella henselae is commonly transmitted through scratches from infected cats, and the presentation of a dog scratch could be a misidentification of the animal.
  • Other Likely diagnoses:
    • Cellulitis: A common infection of the skin and subcutaneous tissues that can occur after a dog scratch, especially if the scratch becomes contaminated with bacteria.
    • Pasteurella multocida infection: This bacterium is commonly found in the mouths of dogs and can be transmitted through bites or scratches, leading to infections.
    • Rabies (if the dog is not vaccinated): Although less common in areas with high vaccination rates, rabies is a significant concern if the dog's vaccination status is unknown.
  • Do Not Miss diagnoses:
    • Tetanus: Although rare, tetanus infection can occur through deep wounds, including scratches, if the tetanus vaccination is not up to date.
    • Rabies (in areas with low vaccination rates or unknown vaccination status): Given the severity and lethality of rabies, it's crucial not to miss this diagnosis, especially in areas where dog vaccination rates are low.
    • Capnocytophaga canimorsus infection: This bacterium is found in the mouths of dogs and can cause severe infections, particularly in individuals with compromised immune systems.
  • Rare diagnoses:
    • Erysipeloid: A rare infection caused by Erysipelothrix rhusiopathiae, which can be transmitted through contact with infected animals, including dogs.
    • Leptospirosis: Although more commonly associated with water exposure, leptospirosis can be transmitted through contact with infected animal tissues, including a scratch from a dog that has the infection.
    • Tularemia: A rare bacterial infection that can be transmitted through contact with infected animals, including dogs, although it's more commonly associated with rabbits and other small mammals.

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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