Cat Scratch Fever: Symptoms, Causes, and What to Expect

Cat scratch disease (CSD) is a bacterial infection caused by Bartonella henselae, transmitted via cat scratches, bites, or flea feces. It’s not congenital—you cannot be born with it.

Typical Timeline

• Inoculation: scratch/bite from infected cat (often kittens)
• Incubation: 3–14 days
• Primary lesion: papule/pustule at site
• Lymphadenopathy: 1–3 weeks later—tender, swollen nodes near injury
• Resolution: 2–4 months (often self-limited)

Common Symptoms

• Swollen, tender lymph nodes (most common)
• Low-grade fever (≤101°F)
• Fatigue, malaise
• Headache
• Decreased appetite
• Muscle/joint aches
• Rash (occasionally)

Rare Complications

• Parinaud’s oculoglandular syndrome (eye + preauricular nodes)
• Neuroretinitis, encephalopathy, seizures
• Osteolytic lesions, endocarditis (in immunocompromised)

Diagnosis & Treatment

• Clinical diagnosis (history + exam)
• Serology (IFA for B. henselae antibodies) if uncertain
• PCR or culture from node aspirate (rarely needed)
• Most cases: Supportive care (warm compresses, analgesics)
• Severe/complicated: Azithromycin 5-day course; other options: rifampin, doxycycline, ciprofloxacin, TMP-SMX
• Immunocompromised: always treat

Prevention

• Wash scratches/bites immediately with soap/water
• Avoid rough play with cats
• Flea control for pets
• Immunocompromised: adopt older cats (>1 year), avoid kittens