Cat scratch disease (CSD) is an infection caused primarily by the bacterium *Bartonella henselae*, typically transmitted through scratches or bites from cats. The treatment approach depends on the severity of the disease, ranging from simple wound care to antibiotic therapy.
The very first and most crucial step after a cat scratch or bite is **immediate and thorough washing of the wound with soap and water**. This helps reduce the risk of infection by physically removing bacteria from the skin surface. The wound should be rinsed under running water for several minutes without scrubbing harshly to avoid tissue damage. After cleaning, applying an antiseptic lotion can further help prevent infection.
For **mild cases of cat scratch disease**, which often involve localized swelling, redness, and sometimes mild fever, the infection may be self-limiting. This means it can resolve on its own without the need for antibiotics. In such cases, supportive care like rest, pain relief with over-the-counter medications (such as acetaminophen or ibuprofen), and monitoring the wound is usually sufficient.
When the disease is **moderate to severe**, or if symptoms persist or worsen, antibiotic treatment is recommended. The first-line antibiotic commonly used is **azithromycin**, which is effective against *Bartonella henselae*. A typical dosage might be 500 mg on the first day followed by a lower dose for several days, but exact regimens depend on the patient’s age, weight, and clinical condition. Other antibiotics that may be used include doxycycline, rifampin, ciprofloxacin, or trimethoprim-sulfamethoxazole, especially in complicated or systemic cases.
In cases where the infection spreads beyond the initial scratch site, causing swollen lymph nodes, fever, or systemic symptoms, antibiotic therapy helps shorten the duration of illness and prevent complications. For immunocompromised individuals or those with severe systemic involvement, more aggressive treatment and hospitalization may be necessary.
If the wound shows signs of secondary bacterial infection—such as increased redness, swelling, pus drainage, or pain—additional antibiotics targeting common skin bacteria may be prescribed. In rare instances, complications like abscess formation might require surgical drainage.
Preventive measures also play a role in managing cat scratch disease. Avoiding rough play with cats, especially kittens, and controlling fleas on pets reduce the risk of transmission. Prompt wound care after any cat scratch or bite is essential to minimize infection risk.
In summary, treatment for cat scratch disease starts with **immediate wound cleaning**, followed by **observation for mild cases**, and **antibiotic therapy for moderate to severe or persistent infections**, with azithromycin being the preferred choice. Supportive care and monitoring for complications are important throughout the course of the illness.
