Red flags & when to go in person for Cat Scratch Disease (Bartonella) - Triage

Audience: adult

Cat Scratch Disease (CSD) is an infection caused by the bacteria Bartonella henselae, usually transmitted through a scratch or bite from a cat. It often causes mild symptoms such as a small bump or blister at the injury site, swollen lymph nodes near the scratch, fever, and fatigue. Most people recover without serious problems. However, some cases can lead to complications requiring in-person medical care. This guide helps you understand when to seek urgent or routine in-person evaluation and what signs to watch for. Telemedicine can assist with initial assessment, education, and monitoring mild symptoms. But if you experience severe pain, worsening swelling, high fever, or other concerning signs, it is important to get prompt in-person care. Early recognition and treatment help prevent complications. This information is educational and not a substitute for professional medical advice or diagnosis.

Red flags — go in person / ER

• High fever above 39°C (102°F) lasting more than 2 days — seek urgent in-person evaluation.
• Rapidly increasing pain, redness, or swelling around the scratch or lymph nodes — get prompt medical care.
• Red streaks spreading from the injury site or signs of spreading infection — go to emergency care immediately.

What telemedicine can do

• Initial symptom assessment and education about Cat Scratch Disease.
• Guidance on home care and symptom monitoring.
• Advice on when to seek in-person care.

What telemedicine cannot do

• Physical examination of the injury and lymph nodes.
• Diagnostic testing such as blood tests or imaging.
• Treatment of severe infections or complications requiring antibiotics or hospitalization.

What is Cat Scratch Disease?

Cat Scratch Disease is an infection caused by the Bartonella henselae bacteria. It usually occurs after a scratch or bite from a cat, especially kittens. The infection often leads to a small bump or blister at the site, followed by swollen lymph nodes nearby. Symptoms typically develop within 1 to 2 weeks after exposure. Most cases are mild and improve on their own or with simple treatment.

Common Symptoms to Expect

Typical symptoms include:

These symptoms usually appear within 1 to 3 weeks and may last several weeks. Many people recover without complications.

When to Seek In-Person Medical Care

Seek urgent in-person care if you notice:

Also, see a healthcare provider promptly if you have a weakened immune system or if symptoms worsen or do not improve after 2 weeks.

How Telemedicine Can Help

Telemedicine can assist by:

However, telemedicine cannot perform physical exams, blood tests, or urgent treatments needed in severe cases.

Preventing Cat Scratch Disease

To reduce your risk:

If you have a cat, regular veterinary care helps keep your pet healthy and lowers infection risk.

How to prepare for your tele-visit

• Have a clear history of your symptoms including when they started.
• Note any recent cat scratches, bites, or exposures.
• Prepare to describe your fever pattern and any swelling or pain.
• List any other medical conditions or medications you are taking.
• Ensure you have a stable internet or phone connection for the tele-visit.

After your tele-visit

• Follow the advice given during the tele-visit carefully.
• Monitor your symptoms daily, especially fever and swelling.
• Keep the affected area clean and avoid further injury.
• Contact your healthcare provider if symptoms worsen or new red flags appear.
• Attend any recommended in-person follow-up appointments for further evaluation.

FAQs

Can Cat Scratch Disease be serious?

Most cases are mild and resolve without problems. However, complications can occur, especially in people with weakened immune systems. Serious issues include infection spreading to other organs or prolonged symptoms, which require medical attention.

How is Cat Scratch Disease treated?

Many mild cases improve without antibiotics. In some cases, doctors prescribe antibiotics to help clear the infection. Treatment decisions depend on symptom severity and individual health factors.

Can I get Cat Scratch Disease from any cat?

The bacteria are more common in kittens and young cats. While any cat can carry Bartonella henselae, the risk is higher with kittens or cats that scratch or bite.

Is there a test for Cat Scratch Disease?

Blood tests can detect antibodies to Bartonella henselae, but diagnosis is often based on symptoms and exposure history. Testing may be done if symptoms are unusual or severe.

How long does it take to recover?

Symptoms usually improve within a few weeks, but swollen lymph nodes may take longer to return to normal. Rest and supportive care help recovery.

Sources

1. Cat Scratch Disease — MedlinePlus, U.S. National Library of Medicine.
2. Cat Scratch Disease (Bartonellosis) — Centers for Disease Control and Prevention (CDC).
3. Cat Scratch Disease — Mayo Clinic.
4. Bartonella Infections — National Institute of Allergy and Infectious Diseases (NIAID).

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care, diagnosis, or treatment. If you have any concerning symptoms or red flags, seek prompt evaluation from a healthcare professional.