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

Audience: pediatric

Cat Scratch Disease (CSD) is an infection caused by bacteria called Bartonella henselae, often spread by a scratch or bite from a cat. It typically causes a mild illness with swelling of lymph nodes near the scratch and sometimes fever. Most children recover well with simple care at home. However, some signs mean your child needs to see a healthcare provider in person quickly. These include high fever, severe pain, swelling that spreads, or signs of infection that worsen or do not improve. Telemedicine can help assess mild symptoms and guide care, but it cannot replace in-person exams when serious symptoms appear. Early recognition of warning signs helps prevent complications and ensures your child gets the right treatment. This guide helps families understand when to seek urgent care for Cat Scratch Disease in children.

Red flags — go in person / ER

• High fever lasting more than 3 days — seek urgent in-person care
• Rapidly growing, painful, or spreading swelling/redness near scratch — see healthcare promptly
• Neurological symptoms like severe headache, confusion, or neck stiffness — emergency evaluation needed

What telemedicine can do

• Assessment of mild symptoms such as small bumps, mild fever, and fatigue
• Guidance on home care and monitoring
• Determining if in-person evaluation is needed

What telemedicine cannot do

• Physical examination for severe or worsening lymph node swelling
• Diagnostic testing such as blood tests or imaging
• Treatment of serious complications or infections requiring antibiotics or surgery

What is Cat Scratch Disease?

Cat Scratch Disease is an infection caused by Bartonella henselae bacteria. It usually happens after a cat scratch or bite. Children often develop a small bump or blister at the scratch site, followed by swollen lymph nodes nearby. Fever and tiredness may also occur. The illness is usually mild and goes away on its own.

Common Symptoms to Watch For

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These symptoms often improve within a few weeks with rest and simple care.

When to Seek In-Person Care

Certain signs mean your child should be seen by a healthcare provider in person as soon as possible:

These may indicate complications needing prompt treatment.

How Telemedicine Can Help

Telemedicine visits can help assess mild symptoms, provide advice on home care, and decide if your child needs to be seen in person. A healthcare provider can review symptoms, look at any visible signs via video, and guide you on next steps. However, telemedicine cannot perform physical exams or tests needed for complicated cases.

Preventing Cat Scratch Disease

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How to prepare for your tele-visit

• Have details ready about the cat scratch or bite (when and how it happened)
• Note all symptoms your child is experiencing, including fever and swelling
• Prepare to show affected areas via video if possible
• List any medications your child is taking
• Be ready to describe any changes in symptoms or new warning signs

After your tele-visit

• Follow home care advice given by the healthcare provider
• Monitor your child’s symptoms closely for any worsening or new signs
• Seek in-person care if red flags develop or symptoms do not improve
• Keep follow-up appointments as recommended
• Ensure your child rests and stays hydrated

FAQs

How long does Cat Scratch Disease usually last?

Most children recover within 2 to 4 weeks with mild symptoms. Swollen lymph nodes may take longer to shrink but usually improve over time.

Can Cat Scratch Disease be spread from person to person?

No, Cat Scratch Disease is not contagious between people. It is spread by cat scratches or bites, often from kittens.

Do all cat scratches cause Cat Scratch Disease?

No, not all cat scratches lead to infection. Many scratches heal without problems. The bacteria are more common in cats with fleas.

When should my child take antibiotics?

Antibiotics are not always needed but may be prescribed if the infection is severe or complications develop. A healthcare provider can decide if antibiotics are appropriate.

Can telemedicine diagnose Cat Scratch Disease?

Telemedicine can help assess symptoms and guide care but cannot confirm diagnosis without physical exams or tests. In-person evaluation may be needed for accurate diagnosis.

Sources

1. Cat Scratch Disease — MedlinePlus, U.S. National Library of Medicine.
2. Cat Scratch Disease (Bartonella henselae) — Centers for Disease Control and Prevention (CDC).
3. Cat-Scratch Disease — Mayo Clinic.
4. Cat Scratch Disease — Merck Manuals Consumer Version.

This telemedicine guidance is for educational and triage purposes only. It is not a substitute for in-person medical care, diagnosis, or treatment. If your child shows any red flag symptoms or if you are concerned, please seek prompt in-person evaluation by a healthcare professional.