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Cat Scratch Fever Or Bartonella henselae Infection


You can read about how Bartonella sometimes affects the eyes of cats here.


Ron Hines DVM PhD

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Cat scratch fever is a bacterial infection of cats and people that is caused by a small, fragile bacteria, Bartonella henselae . There are other bartonella that occasionally cause this disease as well.

Most people develop this disease after being scratched or bitten by an infected cat. It occasionally affects dogs also.

What Signs Would I See In My Cat ?

Most cats that are infected with B. henselae don't show any disease at all. But the bacteria can be cultivated from their blood for long periods after they are first infected.

Infection with Bartonella is very common in domestic cats. We estimate that forty percent of all cats contract bartonellosis sometime in their lives and many cats are asymptomatic carriers for long periods of time.

For a long time, veterinarians thought that bartonella did not cause disease signs in cats. But several cat illnesses have now been linked to Bartonella infection. These include unexplained fevers, deep eye inflammation, enlargement of lymph nodes, generalized muscle pain, inflammations of the heart lining and poor reproductive success.

Some cats with this disease run a fever for two to three days after they first catch Bartonella. But this sign is not usually noticed by their owners.

If your cat is infected and it becomes stressed, it may become apparent that it is ill. Sometimes it is a trip to the vets or a minor surgical procedure that makes the diseases apparent.

A few cats that contract bartonellosis show mild loss of sensation in their paws, lack of balance and disorientation that resolves within a few days. The cat’s lymph nodes may swell and they may become moderately anemic for a few weeks.

At the microscopic level, there is evidence that the organism attacks the liver, kidney, spleen and lining of the heart. But damage to these organs is usually temporary and without symptoms.

Mouth Infections Associated With Bartonella

I occasionally see cats with bad breath and severe mouth infections. This condition is called plasma cell stomatitis or plasmacytic stomatitis. There are clues that Bartonella may be one of the causes of this disease. When these cats test positive for bartonella, they usually also test positive for the cat AIDS virus. These cats often show good improvement when they are given azithromycin antibiotic. However, azithromycin kills many oral bacteria so that is not proof that bartonella was the underlying cause of the mouth problem.

Eye Problems

A high percentage of cats with inflammations of the eye are also positive for bartonella. These conditions include, uveitis, conjunctivitis, chorioretinitis, keratitis and corneal ulcers. These cats often get better when they are given azithromycin, doxycycline antibiotic, or rifampin. Azithromycin is probably the best choice because it also kills other organisms that can be involved in these conditions (mycoplasma). When giving these medications in solid form to cats, you should follow by giving the pet water so that the medication does not lodge in the throat.

What Are The Signs That I Might Have Caught Cat Scratch Fever ?

Most people who contract this disease, caught it from a bite or a scratch from a kitten or cat under six month of age or a stray cat. But older cats can pass this infection to humans too. The disease occurs throughout the World. The majority of cats that spread this disease to people do not look ill. Adult, indoor pet are the least likely to have this disease.

Eighty to ninety percent of the people who catch this disease are young adults, 2-24 years of age, or veterinarians. Most cases occur in the fall and winter months.

People who have been scratched or bitten first develop one or more pustules (pimples) at the site of the wound. A few weeks later, the lymph nodes closest to the wound become swollen and tender. By then the wound may have completely healed and the person may have forgotten about the bite or scratch. These are usually the lymph nodes at the armpit, since most bites and scratches occur on the arms or hands. Mysteriously, patients with no known exposure to cats will occasionally develop the disease.

Fever, headache and fatigue are common signs of this infection. Some people also develop tonsillitis and neck pain. It is rare for more serious signs to develop in healthy people and most people recover over the next three weeks without treatment.

However, when a person’s health is not good or the immune system that protects the person's body is compromised, a series of much more serious signs can occur. The symptoms of this atypical bartonellosis are highly variable but can even be fatal. Often these are people who have undergone organ transplants, chemotherapy or have AIDS.

How Did My Cat Catch Bartonella ?

We are not quite sure in every case. But usually, fleas spread this disease. In the laboratory, cat fleas transmit the disease from one cat to another. I A blood transfusion can also be the source of bartonellosis. Then, when your infected cat scratches on its fleas, it gets infected flea dirt in its claws. If it scratches a person or another cat, it passes on the disease.

Cats in the warmer and more humid portions of the United States have the highest incidence of Bartonellosis. Prevalence ranges from 30-50% of all cats in warm states to 5-7% in colder states. The high-prevalence areas are the same areas where cat fleas are most common.

Bartonella can live in infected cats for at least two years. Some authorities think that fleas can spread the disease to people but others do not. We do know that dried “flea dirt” which is digested blood, can contain living bartonella for over nine days. We think that this dirt becomes lodged under the cat’s claws from where it is passed to people through a scratch. We also suspect that ticks can also transfer the disease to humans. Cat bites can also pass along bartonellosis.

Tick bites are also known to spread the disease. It is possible that cat urine can also spread the disease. When dogs catch bartonella, they may have caught it from ticks.

Can My Dog Catch This Disease ?

Yes, it is possible. But most dogs that have been diagnosed with bartonellosis have a different species of bartonella than cats do.

How Does One Diagnose This Disease ?

In People :

Diagnosis in people is not straight forward or easy. Most physicians rely on a history of exposure to a cat, typical enlarged painful lymph nodes, fever and the lack of another likely cause. Diseases such as tuberculosis, lymphoma and brucellosis need to be ruled out. A skin tests and blood tests for humans are available.

In Pets :

There are 5 tests that can detect if your cat has bartonella. They are the ELISA, PCR, IFA and Western Blot tests as well as an attempt to grow the organism from your pet's blood. However, the tests are not always accurate. Some cats just don't produce enough antibodies against bartonella for the first four tests to be positive. And we do not always grow the organism from the blood of cats that we know are infected. So repeated tests may be necessary.

How Can We Treat Bartonella ?

Although ninety percent of the cases get better without treatment with antibiotics, the cat may take several months to eliminate the disease. Currently, the most reliable medicine we know of is azithromycin antibiotic. It eliminates bartonella in about eighty percent of the cats after about 3 weeks of administration.

Doxycycline, erythromycin,ciprofloxacin, trimethoprim/sulfa, clarithromycin and rifampin antibiotics are also effective in some cases.

Some treated cats are still subject to relapse or becoming carrier cats.

How Can I Keep My Cat and I From Catching Bartonella ?

Keep your cat indoors. When you take it out - take it on a leash or keep it supervised. Indoor cats and supervised cats are much less likely to be exposed to Bartonella. Neuter or spay your cat so it does not have the urge to roam, fight and stress out.

Use one of the newer flea-control products on your cat. Be sure it is one that is still effective in your area.

Do not let your children roughhouse with kittens – especially kittens that were recently obtained from an animal shelter, found as strays or sold in pet shops.

If you or your children are scratched or bitten, vigorously and immediately wash the wound out with warm running water and hydrogen peroxide, isopropyl alcohol or organic iodine (povidine).

If you have sores or scratches on your hand wear gloves when handling your cat or allowing it to lick you.

Keep your cat’s toenails clipped short and filed smooth.

Although it is not one hundred percent effective, high risk people such as those with transplants or immunosupressive disease and those in fragile health should have claw guards placed on their cat's nails or, as an alternative to putting the cat down, have it declawed on all four feet. If they are about to purchase a cat, they should look for an adult cat in good health.