Cat Scratch Disease - Symptoms

Authored by Dr Jacqueline Payne, 19 Jun 2017

Patient is a certified member of
The Information Standard

Reviewed by:
Dr Colin Tidy, 19 Jun 2017

Most people who get cat scratch disease start by getting little spots where their skin has been in contact with a cat's saliva - so a scratch or a bite nasty enough to have broken the skin is the usual cause. If a cat has licked an open wound it can infect you that way too.

  • The spots start as just small red marks.
  • Then they become fluid-filled, like little blisters.
  • Finally they crust over and scab.
  • Sometimes they can be yellow, pus-filled spots.
  • It is common to think that they are insect bites.
  • They appear sometime between 3 and 12 days after you have been scratched or bitten (or licked if you have a cut or graze) by a kitten or a cat.

The next symptom to develop is a swollen gland (lymph node) or glands.

  • Lymph nodes are part of the body's immune system which defends the body against infection.
  • The lymph node that is nearest the place where the spots developed is the one that swells, although others may swell too.
  • The swelling usually starts about two weeks after the scratch.
  • The most common lymph nodes to swell are the ones in the armpit (axilla) and in the head and neck.
  • The swollen lymph node or nodes can get very large - bigger than a tennis ball.
  • Any affected lymph node is painful, hot, red and tender.
  • Sometimes the lymph node can fester and discharge pus (suppurate) - this affects 2 or 3 people out of every 10 who get cat scratch disease.

About half the people who get cat scratch disease only get swollen lymph nodes. The other half can feel generally unwell, with symptoms such as:

  • Aching.
  • Malaise and exhaustion.
  • Going off food.
  • Headache.

About 1 in 10 get a slight temperature (fever), painful joints (arthralgia) and muscle pain (myalgia).

Rarely it can cause:

  • Sudden loss of sight.
  • Tummy (abdominal) pain.
  • Pain in a bone.
  • Confusion.
  • Epileptic fits.
  • Severe headache and being sick (vomiting).

Having an immune system which isn't working properly is called immunodeficiency. If you have HIV or AIDS or are on treatment that suppresses your immune system, such as chemotherapy, the symptoms can be worse and you are more likely to feel ill. It can be very serious and even life-threatening if not treated .

Other symptoms you may develop are:

  • A rash: raised red or purple spots, which can bleed if knocked.
  • High fever.
  • Feeling sick (nausea) and being sick (vomiting).
  • Becoming short of breath.
  • Bringing up blood.

Further reading and references

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