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1Fix the driver behind crashes, sound loss and screen glitches2Clear out junk files and repair common Windows errors3Scan for outdated or missing drivers - takes under a minuteCat-scratch disease (CSD), also called cat-scratch fever, is an infection caused by Bartonella henselae. It can cause a bump or pustule where the bacteria entered and tender, swollen lymph nodes, often appearing one to three weeks after cat exposure. Most cases resolve without antibiotics, but people with weakened immune systems and those with severe or disseminated disease need medical care.
Wash a cat bite or scratch promptly with soap and water. Contact a healthcare professional for a fever, a pustule at the scratch site, or tender enlarged lymph nodes after cat exposure; also seek advice for a serious or worsening wound, a sick cat, uncertain rabies vaccination status, or a tetanus shot more than five years ago. (Centers for Disease Control and Prevention, 2026; MedlinePlus, 2024.)
What is cat-scratch fever?
“Cat-scratch fever” is the common name for cat-scratch disease, a zoonotic infection caused by Bartonella henselae. The name can be misleading: it is not simply a fever after every cat scratch, and most cat scratches do not cause CSD.
CSD is also different from:
- A routine wound infection: bacteria introduced into a bite or scratch can cause worsening redness, warmth, swelling, pain, or drainage.
- Tetanus: a separate infection risk associated with certain wounds and vaccination history.
- Rabies: a rare but life-threatening viral disease requiring urgent risk assessment after some exposures.
Swollen lymph nodes after contact with a cat do not prove CSD. A healthcare professional can consider the exposure, symptoms, immune status, and other possible causes.
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How people get cat-scratch disease
Cats can carry B. henselae without looking sick. Scratches from domestic or feral cats—especially kittens—are the usual exposure. A scratch can transmit the bacteria when contaminated with infected flea feces. Infected cat bites and a cat licking an open wound can also spread it. CDC notes that direct transmission to people from a cat flea bite is possible but has not been proven. (CDC, 2026.)
Direct person-to-person spread is not expected. CSD can affect people of any age, though it is more common among children younger than 15. (CDC, 2026.)
Cat-scratch disease signs and timeline
Symptoms vary, and not everyone has every feature. The symptoms alone do not establish a diagnosis.
1. A bump or pustule at the injury site
A papule or pustule may form where the bacteria entered. It can be easy to mistake for an ordinary insect bite or minor skin irritation. A visible lesion is not always present or noticed.
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Tender, enlarged lymph nodes may develop one to three weeks after exposure. (CDC, 2026.) The nodes are often near the area of the scratch: an injury on the hand or arm may be followed by swollen nodes in the armpit, while a leg injury may be associated with groin nodes.
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3. General symptoms
Some people develop:
- Low-grade fever
- Fatigue or feeling unwell
- Headache
- Reduced appetite
A scratch history helps a clinician assess the pattern, but a visible scratch is not required for CSD to be considered.
When cat-scratch disease can be serious
Most infections remain uncomplicated and resolve without antibiotics. Rarely, infection can affect the eyes, liver, spleen, brain, bones, or heart valves. Severe infections occur primarily in some people with weakened immune systems, including people with advanced HIV. (CDC, 2026.)
Seek prompt medical care for concerning symptoms
Get medical evaluation for new vision problems, neurologic symptoms, significant or persistent abdominal symptoms, prolonged fever, or rapidly worsening illness. Seek advice promptly if you have a weakened immune system and develop symptoms after cat exposure. These symptoms can have causes other than CSD, but warrant professional assessment.
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- Wash the injury promptly. Use soap and running water, even if the injury looks small.
- Control minor bleeding. Apply gentle pressure with clean gauze or a clean cloth if needed.
- Watch for wound problems. Seek medical attention if the wound is serious or becomes red, painful, warm, or swollen. (CDC, 2026.)
- Check tetanus status. Contact a healthcare professional if it has been more than five years since your last tetanus shot after a cat bite or scratch. (CDC, 2026.)
- Assess rabies risk. Seek advice if the cat appears sick or its rabies vaccination status is unknown. (CDC, 2026.)
Soap and water are immediate wound care. They do not treat established cat-scratch disease. Cat bites deserve particular attention; get medical advice for a serious or worsening bite.
How doctors diagnose cat-scratch disease
A typical case can often be diagnosed from cat exposure and compatible symptoms. Laboratory testing is generally unnecessary in typical cases, but may help when illness is severe or atypical. (CDC, 2026.)
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Blood antibody testing
Serology can support a diagnosis, but antibodies may cross-react with other Bartonella species and remain positive for years after treatment. A positive result does not necessarily prove that active CSD is causing current symptoms. (CDC, 2026.)
Other tests and lymph-node aspiration
A clinician may select additional tests when the presentation is severe or atypical. Lymph-node aspiration is generally not recommended except to relieve severe pain and swelling or when the diagnosis is unclear. Never attempt to puncture or drain a swollen lymph node at home. (CDC, 2026.)
Cat-scratch fever treatment
Uncomplicated illness
Most CSD cases resolve without antibiotic treatment. For an otherwise healthy person, treatment can depend on severity and clinician and patient preference. (CDC, 2026.)
In a small study, a short course of azithromycin reduced lymph-node volume more quickly, but overall health outcomes did not differ between treated and untreated patients. This is not a recommendation to self-treat. Do not use leftover antibiotics; a healthcare professional should decide whether treatment is appropriate.
Severe, disseminated, or immunocompromised disease
Antibiotics are required for immunocompromised patients. Severe or disseminated disease—including some eye, liver, or heart-valve presentations—may require longer treatment and more than one antibiotic, under clinician and sometimes specialist guidance. (CDC, 2026.)
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How long does cat-scratch disease last?
Most cases resolve without antibiotics, though recovery can take time. Follow a healthcare professional’s advice if symptoms persist or worsen, or if the illness seems severe or atypical.
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- Avoid rough play that encourages scratches or bites, especially with kittens.
- Wash your hands after handling cats and clean scratches with soap and water.
- Do not allow a cat to lick an open wound.
- Keep cats indoors and away from stray cats where practical.
- Ask a veterinarian about flea prevention. Never use permethrin-containing products on cats. (CDC, 2026.)
- Do not declaw a cat as a CSD-prevention strategy.
People with weakened immune systems do not necessarily need to give up cat ownership. CDC advises keeping cats indoors and avoiding adopting cats younger than one year. Ask a healthcare professional and veterinarian for individualized advice. Healthy cats generally should not be tested or treated for B. henselae; a cat that appears ill should be evaluated by a veterinarian. (CDC, 2026.)
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.Cat-scratch disease versus an infected scratch
| Feature | Cat-scratch disease | Wound infection |
|---|---|---|
| Typical pattern | A bump or pustule may form; tender nearby lymph nodes may develop one to three weeks after exposure. | The wound becomes red, painful, warm, or swollen. |
| Cause | Bartonella henselae, usually transmitted through a scratch contaminated with flea feces, a bite, or a lick on open skin. | Other bacteria introduced into the wound may be responsible. |
| Next step | Contact a healthcare professional for compatible symptoms; treatment depends on the case. | Seek medical attention if the wound is serious or becomes red, painful, warm, or swollen. |
The two conditions can overlap. Do not dismiss a serious or worsening wound as cat-scratch disease.
When to call a healthcare professional
CDC advises contacting a healthcare provider for fever, tender enlarged lymph nodes one to three weeks after cat exposure, or a pustule at the scratch site. Seek medical attention for a serious or worsening wound, a sick cat, uncertain rabies vaccination status, or a tetanus shot more than five years ago. (CDC, 2026.)
FAQ
Can you get cat-scratch disease without seeing a scratch?
Yes. A mark may be tiny or unnoticed. A clinician can consider CSD based on cat exposure and compatible symptoms, including nearby swollen lymph nodes.
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Do all cat scratches cause cat-scratch disease?
No. Most cat scratches do not cause CSD. Transmission is associated with B. henselae, including bacteria transferred when a scratch is contaminated with flea feces.
Does cat-scratch disease always need antibiotics?
No. Most cases resolve without antibiotics. CDC says antibiotics are required for immunocompromised patients; a clinician determines care for other cases.
Can I treat cat-scratch disease by cleaning the wound?
Wash a fresh scratch or bite with soap and water, but this is immediate wound care, not treatment for established CSD. Contact a healthcare professional for fever, a pustule, or tender enlarged lymph nodes.
Should I test or treat my healthy cat for Bartonella?
Routine testing or treatment of a healthy cat is not recommended solely because a person is concerned about CSD. Ask a veterinarian about flea prevention and seek veterinary care if the cat appears ill.
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The Bottom Line
Cat-scratch disease can cause a bump or pustule and tender swollen lymph nodes, often one to three weeks after cat exposure. Most cases resolve without antibiotics, but symptoms and wound risks should be assessed by a healthcare professional. Wash bites and scratches promptly, and seek advice for fever, swollen nodes, a pustule, a serious or worsening wound, or risks involving tetanus, rabies, or weakened immunity.
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