Cat Scratch Fever

Childhood Infections

Black cat in living room peeking over arm rest of sofa
Cat scratch fever. bryantscannell / Getty Images

Cat scratch fever or cat scratch disease, as it is also known, is a fairly common, although not well known infectious disease in children.

And it is likely not more well known among parents, because although the name makes it sound like a serious condition, children with cat scratch fever do not usually get very sick and typically get better on their own without any treatments.

Cat Scratch Fever Symptoms

Children with cat scratch fever develop a brownish-red bump or sore about 7 to 12 days after being scratched, bitten, or licked by a cat, or more commonly a kitten, at the same site as the initial wound.

A few weeks later, they will develop a slowly enlarging lymph node or gland in the same area. For example, if they were scratched on the arm, they may have an enlarged gland in their armpit.

Other symptoms can include fever and that the enlarged gland becomes red, warm, and that it hurts. The gland may also begin draining.

Less commonly, children will also complain of being tired and will have a decreased appetite, a rash, or a sore throat, which can mimic symptoms of strep throat or mono.

Most children appear well, though, except for the fact that they have this lymph gland that keeps getting bigger.

Children with cat scratch fever can also have atypical symptoms, such as pink eye (Parinaud's oculoglandular syndrome), fever without other symptoms, headache, or seizures.

Diagnosing Cat Scratch Fever

Pediatricians usually diagnosis cat scratch fever based on the pattern of symptoms, especially if the parent or child remembers the kitten scratch.

Unfortunately, since symptoms may not develop until a few weeks later, children don't always remember or associate the cat scratch with their current symptoms. Blood tests to check Bartonella henselae titers, the bacteria that causes cat scratch fever, can also be done.

Testing might also be done to exclude other causes of an enlarged lymph gland, such as mono and strep throat.

Treating Cat Scratch Fever

Although many children with cat scratch fever end up being treated with antibiotics, including Zithromax, Bactrim, and rifampin, some experts think that they don't really work and that treatment is not necessary.

Keep in mind that the enlarged lymph glands that come with scratch fever can sometimes linger for months.

What To Know About Cat Scratch Fever

Other things to know about cat scratch fever include that:

  • Children are more likely to get cat scratch fever from kittens than adult cats, and from stray cats versus their own pet cat. This may be because fleas are thought to spread the bacteria that causes cat scratch fever to cats. It may also be possible that the bacteria is spread to children directly from the infected fleas.
  • Cat scratch fever is not contagious from one person to another.
  • You can likely prevent cat scratch fever by not allowing your child to play with stray cats and making sure your pet cat doesn't have fleas. If your child is bitten or scratched by a kitten or cat, be sure to wash the wound right away and watch for signs of cat scratch fever in the weeks to come.
  • Cat scratch fever can be a much more serious disease for children with immune system problems.
  • Kittens that are infected with Bartonella henselae are usually not sick and don't need to be tested or treated.

Talk to your pediatrician if you think your child has cat scratch fever, although you should keep in mind that most kids who get bit or scratched by a kitten will not develop symptoms.


Batts S. Spectrum and treatment of cat-scratch disease. Pediatr Infect Dis J - 01-DEC-2004; 23(12): 1161-2

Long: Principles and Practice of Pediatric Infectious Diseases, 2nd ed.

Robin English. Cat Scratch Disease. Pediatr. Rev., Apr 2006; 27: 123 - 128.

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