- IF the skin is only contused and not broken, then simply cleanse the skin thoroughly with soap and water. There is no reason to seek further care unless signs of infection (see below) occurs over the next few days.
- IF the skin is penetrated, copious irrigation is warranted, in addition to thorough cleansing. See your medical doctor or go to the emergency department, especially if you are immunosuppressed or your tetanus is not up-to-date or there is more to the injury (lacerations, continued bleeding, etc).
- Basic wound management is the key. Treatment may include debridement, antibiotic therapy, supportive care, and, possibly, primary suturing or hospitalization with operative debridement. Only 1-3% of all bite injuries (dog, cat, etc)require hospitalization for surgical debridement and intravenous antibiotics.
- Tetanus toxoid is administered. The rabies status of the animal will be investigated.
- The force of a domestic cat's bite does not match that of a dog. Its sharp teeth may cause a puncture wound into which bacterial organisms are inoculated. The risk of infection is compounded by the feline habit of paw licking, which may contaminate their claws with oral flora. The risk of infection is higher following a cat bite than a dog bite. Also, cat bites carry the risk of causing catscratch fever with resultant adenopathy. This is usually self-limited except in immunosuppressed patients.
- Signs of infections are typical and include redness(rubor), pain (dolor), heat (calor), and swelling (edema) of the tissues. Purulent discharge from the wound is another good indicator of infection. Signs of infections may appear 24-72 hours following the bite.
Patients with mild-to-moderate catscratch disease should not receive antibiotics.
For patients with extensive symptomatic lymphadenopathy, azithromycin is recommended.
All immunocompromised patients with catscratch disease, however, should be treated with antibiotics.
For retinitis, a combination of doxycycline and rifampin for 4-6 weeks is recommended.
Catscratch Disease; eMedicine Article, August 15, 2006; Roseanne Ressner DO, Lynn Horvath MD
Animal Bites; eMedicine Article, August 1, 2006; Suzanne Galli MD, Philip Miller MD
Bartonellosis; eMedicine Article, October 31, 2007; Kassem Hammoud MD, Daniel Hinthorn MD