Cause
Cat scratch disease is caused by the bacterium Bartonella henselae, usually transmitted through a cat scratch.
Symptoms
About one-half to three-fourths of children diagnosed have a cat scratch on their bodies. Within 3 to 10 days after the scratch, a blister or small bump develops. Usually within two weeks of the scratch, lymph nodes (glands) near the scratch swell. The nodes may be painful and surrounded by a larger area of swelling under the skin, which may be red. About one-third of children develop fever, fatigue, loss of appetite, and headache. In a few cases, the bump appears as a small sore on the conjunctiva (lining of the eye surface), with swollen nodes in the area around the ears.
How It Spreads
It is transmitted by a scratch from an infected animal, most often a kitten. It is not spread from person to person.
Incubation Period
It takes 3 to 10 days for a blister or bump to appear at the site of the scratch. Lymph node swelling starts about two weeks after the scratch, with a range of 7 to 60 days.
How Long Symptoms Last
Usually nodes are swollen for one to two months, but swelling may last much longer.
When to Call Your Child’s Doctor
Call your child’s doctor if your child has been scratched by a cat or kitten and develops swollen glands and a fever.
How the Diagnosis Is Made
Exposure to a cat or kitten is the first clue. The doctor may order a blood test for cat scratch disease as well as other skin and blood tests to rule out other causes of swollen lymph nodes.
Treatment
The doctor may or may not prescribe antibiotics. Even without antibiotics, the disease will go away in time.
Home Treatment
The child does not have to be isolated from the rest of the family. Avoid injuring areas of the swollen lymph nodes. Moist compresses of salty water may help soothe painful nodes.
Prevention
Teach children to avoid stray or unfamiliar cats. If your child is scratched by a cat or other pet, wash the area thoroughly with soap and water.
Contagious Periods
For unknown reasons, cat scratch disease occurs more often in fall and winter. Kittens are more often infected with the bacteria than mature cats; once infected they carry the bacteria for months.
Complications
A small number of children (less than 5 percent) develop seizures, bizarre behavior, or other neurologic symptoms several weeks after lymph node swelling appears.