From Vincent Iannelli, M.D.,
Your Guide to Pediatrics.
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Cat scratch fever or cat scratch disease, as it is also known, is a fairly common, although not well known infectious disease in children. And it is likely not more well known among parents because although the name makes it sound like a serious condition, children with cat scratch fever do not usually get very sick and typically get better on their own without any treatments.

Cat Scratch Fever Symptoms

Children with cat scratch fever develop a brownish-red bump or sore about 7 to 12 days after being scratched, bitten, or licked by a cat, or more commonly a kitten, at the same site as the initial wound. A few weeks later, they will develop a slowly enlarging lymph node or gland in the same area. For example, if they were scratched on the arm, they may have an enlarged gland in their armpit.

Other symptoms can include fever and that the enlarged gland becomes red, warm, and that it hurts. the gland may also begin draining.

Less commonly, children will also complain of being tired and will have a decreased appetite, a rash, or a sore throat, which can mimic symptoms of strep throat or mono.

Most children appear well though, except for the fact that they have this lymph gland that keeps getting bigger.

Children with cat scratch fever can also have atypical symptoms, such as pink eye (Parinaud's oculolandular syndrome), fever without other symptoms, headache, or seizures.

Diagnosis of Cat Scratch Fever

Pediatricians usually diagnosis cat scratch fever based on the pattern of symptoms, especially if the parent or child remembers the kitten scratch. Unfortunately, since symptoms may not develop until a few weeks later, children don't always remember or associate the cat scratch with their current symptoms. Blood tests to check Bartonella henselae titers, the bacteria that causes cat scratch fever, can also be done.

Testing might also be done to exclude other causes of an enlarged lymph gland, such as mono and strep throat.

Cat Scratch Fever Treatments

Although many children with cat scratch fever end up being treated with antibiotics, including Zithromax, Bactrim, and rifampin, some experts think that they don't really work and that treatment is not necessary.

Keep in mind that the enlarged lymph glands that come with scratch fever can sometimes linger for months.

What You Need To Know

• Children are more likely to get cat scratch fever from kittens than adults cats, and from stray cats versus their own pet cat. This may be because fleas are thought to spread the bacteria that causes cat scratch fever to cats. Although kittens are thought to have the bacteria that causes cat scratch fever in their saliva, they can get it on their paws when they lick themselves.
  
  
• Cat scratch fever is not contagious from one person to another.
  
  
• You can likely prevent cat scratch fever by not allowing your child to play with stray cats and making sure your pet cat doesn't have fleas. If your child is bitten or scratched by a kitten or cat, be sure to wash the wound right away and watch for signs of cat scratch fever in the weeks to come.
  
  
• Cat scratch fever can be a much more serious disease for children with immune system problems.
  
  
• Kittens that are infected with Bartonella henselae are usually not sick and don't need to be treated.
  
  

References:
¹Robin English. Cat Scratch Disease. Pediatr. Rev., Apr 2006; 27: 123 - 128.
²Long: Principles and Practice of Pediatric Infectious Diseases, 2nd ed.
³Spectrum and treatment of cat-scratch disease.Batts S - Pediatr Infect Dis J - 01-DEC-2004; 23(12): 1161-2