From the Guidelines
Cat scratches during pregnancy are generally not a major concern, but they can potentially lead to cat scratch disease (CSD), caused by the bacteria Bartonella henselae, and if long-term suppression of Bartonella infection is required, erythromycin should be used, as tetracyclines should not be used during pregnancy. If you're pregnant and have been scratched by a cat, clean the wound thoroughly with soap and water, then apply an antiseptic like hydrogen peroxide or povidone-iodine. Monitor the scratch for signs of infection such as redness, swelling, warmth, or pus. If these symptoms develop, or if you experience fever, fatigue, or swollen lymph nodes, contact your healthcare provider immediately.
Key Considerations
- Treatment for CSD typically involves antibiotics, but the choice of antibiotic is crucial during pregnancy, with erythromycin being recommended for long-term suppression of Bartonella infection 1.
- While CSD rarely causes serious complications in healthy adults, pregnant women should be especially cautious as their immune systems are somewhat suppressed.
- To prevent cat scratches, avoid rough play with cats, keep your cat's nails trimmed, and wash hands after handling cats.
- The risk of toxoplasmosis from cats is a separate concern during pregnancy, primarily from cat feces rather than scratches.
Prevention and Management
- Avoid rough play with cats and situations in which scratches are likely, and any cat-associated wound should be washed promptly 1.
- Care of cats should include flea control, and no evidence indicates any benefits to cats or their owners from routine culture or serologic testing of the pet for Bartonella infection 1.
- If long-term suppression of Bartonella infection is required, erythromycin should be used, as tetracyclines should not be used during pregnancy 1.
From the Research
Cat Scratch Disease and Pregnancy
- Cat scratch disease is a bacterial infection caused by Bartonella henselae, which can be transmitted to humans through cat scratches or bites 2.
- A study published in 2012 found that pregnant women with cat scratch disease had a low risk of transmitting the infection to their newborns, and most women gave birth to healthy babies without congenital anomalies 2.
- However, one woman in the study had a spontaneous abortion, and another elected to terminate the pregnancy due to concerns related to radiation from an abdominal computed tomography scan 2.
Clinical Manifestations of Cat Scratch Disease
- Cat scratch disease can cause a range of clinical manifestations, including regional lymphadenitis, arthralgia, myalgia, erythema nodosum, and neuroretinitis 2, 3.
- A study published in 2021 found that the disease spectrum of Bartonella henselae infection included lymph node disease, organ peliosis, endocarditis, cutaneous lesions, parapharyngeal abscess, parotitis, and neurologic and ocular syndromes 3.
- The severity of the infection can range from benign and self-limited to severe and life-threatening, and the clinical manifestations can vary depending on the patient's immune status 4.
Treatment of Cat Scratch Disease
- The treatment of cat scratch disease typically involves antibiotics, such as azithromycin, doxycycline, and gentamicin 4, 5.
- A study published in 2021 found that azlocillin combined with azithromycin may be an effective drug combination for the treatment of Bartonellosis 5.
- However, the treatment of chronic infection remains problematic, and more research is needed to determine the optimal diagnostic and therapeutic approach 2, 5.