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Cat bite

A cat bite is a puncture wound inflicted by a cat's sharp teeth, which often penetrates deeply into skin, muscle, or even bone and joint structures, introducing oral bacteria and posing a significant risk of infection in humans.^[1] These injuries typically occur during interactions with domestic cats in residential settings, with the highest incidence among women over 80 years old and during summer months.^[1] Globally, cat bites represent 2–50% of animal bite injuries, second only to dog bites, and are twice as likely to become infected due to the narrow, deep nature of the wounds that trap pathogens.^[2] The primary health concern with cat bites is bacterial infection, occurring in approximately 30% of cases, with common pathogens including Pasteurella multocida, staphylococci, streptococci, and anaerobes that can lead to cellulitis, lymphangitis, abscesses, osteomyelitis, or sepsis within 12–18 hours of the bite.^[1] Additional risks include rare zoonotic diseases such as tularemia,^[3] Bartonella infections (cat scratch disease), or rabies transmission, particularly in unvaccinated cats or endemic areas; children face heightened severity due to bites on the face, neck, or head.^[2] In the United States, cat bites prompt about 66,000 emergency department visits annually, underscoring their medical burden.^[2] Prompt medical evaluation is essential for all cat bites to assess infection risk and provide appropriate care, including wound management and prophylactic antibiotics where indicated.

Introduction and Overview

Definition and Characteristics

A cat bite is defined as a puncture or laceration wound inflicted by the teeth of a domestic or wild cat, typically resulting from defensive or playful behavior.^[4] These wounds are characterized by their narrow and deep nature, primarily due to the cat's sharp, elongated canine teeth and limited jaw gape, which contrasts with the broader crushing injuries often seen in dog bites.^[5] The punctures average deeper penetration relative to the wound's surface area compared to dog bites, with cats exerting less overall biting force—typically under 200 pounds per square inch—leading to less soft tissue crushing but higher risk of deep inoculation.^[6] This anatomy causes the skin to seal rapidly over the entry points, creating an enclosed anaerobic environment that traps debris and hinders natural drainage.^[7] Biologically, cat bites introduce a diverse microbial load from feline oral flora, including aerobic bacteria such as Pasteurella multocida—the most prevalent pathogen, isolated in up to 54% of infected cat bite wounds—and Capnocytophaga species, alongside anaerobes like Fusobacterium and Bacteroides.^[8]^[9] These organisms thrive in the low-oxygen conditions of puncture wounds, contributing to the elevated infection rates observed in cat bites, which exceed those of dog bites by approximately 2-3 times.^[10]^[11] The medical recognition of cat bites as high-risk for severe infections dates to early 20th-century reports, with the first documented case of Pasteurella multocida infection from a cat bite described in 1930, highlighting the need for prompt intervention due to rapid bacterial proliferation.^[12]

Risk Factors and Common Scenarios

Individuals at higher risk for severe outcomes from cat bites include those who are immunocompromised, such as people with diabetes, HIV/AIDS, or undergoing immunosuppressive treatments, due to increased susceptibility to bacterial infections from the cat's oral flora.^[13]^[14] Children under 5 years old and adults aged 65 and older also face elevated risks, as their developing or weakened immune systems make them more prone to complications like sepsis or localized infections following a bite.^[15] Veterinary workers and animal care professionals experience heightened occupational exposure, with studies showing that up to 86% of reported bites and scratches in this group involve cats, often leading to infections in about 20% of cases.^[16] Cat-related factors that increase bite likelihood and severity include encounters with stray or feral animals, which are often unvaccinated and carry a higher risk of transmitting pathogens like rabies due to their outdoor lifestyles and potential wildlife interactions.^[17] Aggressive behaviors in cats, such as play aggression in young or under-socialized animals and territorial defense in response to perceived threats, commonly precipitate bites; for instance, play-motivated attacks involve pouncing and biting during interactive sessions, while territorial responses target intruders with swats or chases.^[18] Common scenarios for cat bites occur in household settings, where approximately 64% of incidents involve family-owned pets during rough play or handling, often provoked by the victim's actions like grabbing the cat.^[19] Outdoor encounters with stray cats, particularly in areas with high feral populations, account for a notable portion of unprovoked bites, while occupational exposures in veterinary clinics frequently arise during examinations or restraint of fractious animals.^[16] These bites are associated with infections from oral bacteria, though detailed microbiology is covered elsewhere.^[15] Statistical risk profiles indicate that, in a study from the Valencian Region of Spain, the annual incidence of feline aggression acts, predominantly bites, was 6.36 per 100,000 people, with variations by setting; animal bite emergency visits, including those from cats, occur at rates 1.7 times higher in rural areas (640 per 100,000) compared to urban areas (371 per 100,000) in the U.S., reflecting greater stray populations and outdoor exposures in rural environments.^[19]^[20] In regions like parts of Asia, rural incidences exceed urban, driven by higher densities of unvaccinated feral cats.^[21]

Clinical Presentation

Signs and Symptoms

Cat bites typically present with immediate local symptoms due to the deep puncture nature of the wounds caused by sharp feline teeth. Within hours of the injury, patients often experience sharp pain at the site, followed by visible puncture marks that may appear as small, deep holes. Redness (erythema) and swelling (induration) develop rapidly, usually within 12 to 24 hours, accompanied by warmth to the touch as inflammation progresses. In many cases, these local signs intensify, leading to pus formation (purulent drainage) and the appearance of red streaks (lymphangitis) extending from the wound, signaling spreading infection.^[1]^[22] The timeline of symptom onset is notably rapid compared to other types of wounds, with approximately 70% of infections manifesting within 24 hours and 90% by 48 hours post-bite. This accelerated development is attributed to the introduction of oral bacteria deep into tissues, where the narrow puncture wounds seal quickly, trapping pathogens and promoting anaerobic conditions conducive to bacterial growth.^[22]^[1] Systemic early signs are less common but can occur in severe cases, including low-grade fever, chills, and malaise, particularly if the infection disseminates. Regional lymphadenopathy, or swollen lymph nodes near the bite site, may also emerge as an early indicator of lymphatic involvement. These symptoms underscore the potential for infection escalation if not addressed promptly.^[1]^[22] Symptom severity varies by bite location, with hand bites often being more symptomatic due to the area's limited vascularity and small compartments, which hinder natural clearance of bacteria and increase risks of deep infections like cellulitis or tenosynovitis; up to 36% of hand cat bites become infected. In contrast, facial bites, while carrying a lower overall infection risk owing to the region's rich vascular supply, pose greater concern for rapid spread to critical structures such as the eyes or brain if infection occurs.^[1]^[23]^[6]

Initial Wound Assessment

Upon presentation, the initial wound assessment for a cat bite begins with a thorough physical examination to evaluate the injury's extent and potential complications. The clinician should first inspect the wound for its size, depth, and type, noting that cat bites typically produce deep puncture wounds due to the sharp, needle-like teeth that can inoculate bacteria subcutaneously. Exploration involves gently probing the site to identify foreign bodies, such as retained tooth fragments, which may necessitate radiographic imaging if suspected. Neurovascular status must be assessed by checking capillary refill, pulses, sensation, and motor function distal to the wound to rule out vascular compromise or nerve injury. Additionally, range of motion testing helps detect tendon or joint involvement, particularly in bites to the hands or extremities where such structures are at higher risk.^[1]^[10] Evaluation of tetanus and rabies risks follows the physical exam. Tetanus prophylaxis is indicated if the patient's last booster was more than 5 years ago, with tetanus immune globulin considered for those with unknown or incomplete vaccination history. For rabies, the clinician assesses the cat's vaccination status, behavior, and local epidemiology; if the animal is unvaccinated, stray, or exhibits abnormal signs, post-exposure prophylaxis—including rabies immune globulin and vaccine series—should be initiated promptly per CDC guidelines. Swelling, a common early sign, may accompany these assessments but requires monitoring without overshadowing structural evaluation.^[1]^[10]^[24] Severity is classified based on wound characteristics, distinguishing superficial lacerations from deep punctures, the latter carrying a higher infection risk of approximately 30% due to bacterial inoculation. Bites involving deeper tissues, such as those penetrating beyond the skin into muscle or near bones, warrant closer scrutiny. High-risk features include location on the hands, face, or over joints, as well as patient factors like immunosuppression or diabetes.^[1]^[10] Emergency care is essential for certain presentations to prevent rapid progression to severe infection or systemic issues. Immediate referral is recommended for bites to the face, joints, or genitals; deep punctures with signs of tendon involvement; or in high-risk patients such as the elderly, immunocompromised individuals, or those with delayed presentation beyond 6-12 hours. Extensive tissue damage, neurovascular deficits, or suspected rabies also necessitate urgent evaluation in an emergency setting.^[1]^[10]

Pathophysiology and Complications

Microbial Infections

Cat bites frequently result in microbial infections due to the inoculation of bacteria from the cat's oral flora into human tissues. The primary pathogen is Pasteurella multocida, isolated from approximately 75% of infected cat bite wounds, reflecting its high prevalence in feline saliva (70-90% carriage rate).^[25] Other common aerobes include Streptococcus spp. and Staphylococcus spp., while anaerobes such as Fusobacterium nucleatum and Bacteroides spp. contribute to polymicrobial infections in up to 50% of cases.^[26] These infections often manifest as polymicrobial, with multiple species isolated from a single wound.^[27] The mechanism of infection in cat bites involves deep puncture wounds that deliver bacteria directly into subcutaneous tissues, joints, or bones, bypassing superficial barriers. This inoculation traps pathogens as the small entry wound seals rapidly, fostering anaerobic conditions conducive to proliferation and leading to complications like abscesses, cellulitis, or osteomyelitis.^[1] Unlike lacerations from dog bites, the narrow, tooth-shaped punctures from cats increase the risk of deep-tissue involvement and delayed drainage, exacerbating bacterial spread.^[28] Pasteurellosis, caused by P. multocida, is characterized by rapid onset, with symptoms of intense pain, erythema, and edema appearing within hours of the bite due to the bacterium's virulence factors, including capsule production and endotoxin release.^[29] This swift progression can lead to tenosynovitis or septic arthritis if the bite affects the hand or joint. Bartonella henselae, associated with cat scratch disease, can also be transmitted via bites, particularly if saliva contaminates the wound, resulting in regional lymphadenopathy and fever, though scratches remain the primary vector.^[30] Emerging antibiotic resistance in feline oral flora poses challenges, with P. multocida isolates showing resistance to penicillins and β-lactam antibiotics in a minority of human cases from animal bites (18 out of 482 reported infections as of 2025).^[31] A study of cat-derived P. multocida isolates reported high resistance rates to ampicillin (97%) and clindamycin (76%), potentially driven by veterinary antibiotic use, though the pathogen remains generally susceptible to amoxicillin-clavulanate.^[32] These patterns underscore the need for culture-guided therapy in severe infections.^[33]

Systemic and Long-Term Complications

Cat bites can lead to severe systemic infections, particularly in vulnerable populations such as the elderly, immunocompromised individuals, or those with underlying health conditions. Sepsis is a critical complication, often resulting from bacterial dissemination via the bloodstream, with pathogens like Pasteurella multocida and Capnocytophaga species implicated in cases following cat bites. ^[1] ^[34] Endocarditis, an inflammation of the heart valves, has been reported in rare instances, commonly associated with Bartonella henselae from cat-scratch disease that progresses beyond localized symptoms. ^[35] ^[36] Meningitis, involving infection of the brain and spinal cord membranes, can also occur, especially when bites introduce bacteria directly into the central nervous system or via hematogenous spread. ^[1] ^[37] While rare zoonotic transmissions like toxoplasmosis are not typically associated with cat bites themselves, other systemic effects from cat-associated pathogens underscore the need for prompt intervention in at-risk patients. ^[38] Long-term complications from untreated or severe cat bites often involve persistent bone and joint infections, leading to chronic morbidity. Chronic osteomyelitis, a prolonged bone infection, may develop if bacteria such as Pasteurella multocida penetrate deep tissues, requiring extended antibiotic therapy and potential surgical debridement. ^[39] ^[40] Septic arthritis, an infection within joint spaces, is particularly concerning in hand bites due to the puncture nature of feline wounds, potentially causing joint destruction and reduced mobility if not addressed early. ^[1] ^[41] Scarring from deep wounds can result in functional impairment, including nerve damage, tendon adhesions, or limited range of motion, especially in the hands where cat bites frequently occur. ^[42] Infection rates for cat bites are notably high, estimated at 20% to 50% overall, with escalation to systemic involvement necessitating hospitalization in approximately 10% to 30% of cases, particularly for hand injuries. ^[43] ^[23] ^[44] Psychological impacts, though less studied specifically for cat bites compared to larger animal attacks, can include persistent fear of animals or symptoms akin to post-traumatic stress disorder (PTSD) in victims of repeated incidents, with evidence from broader animal bite research indicating anxiety, phobias, and nightmares as common sequelae. ^[45]

Diagnosis and Evaluation

Clinical Diagnosis

The clinical diagnosis of cat bite injuries begins with a thorough history-taking to contextualize the injury and assess infection risk. Key elements include the circumstances of the bite, such as whether it was provoked or unprovoked, the location and timing of the event, and the type of wound inflicted—typically deep punctures from feline teeth that penetrate subcutaneous tissues.^[1] The patient's medical history is essential, encompassing comorbidities like diabetes, immunosuppression, or peripheral vascular disease that elevate infection susceptibility, as well as the symptom timeline, where signs often emerge within 12 to 24 hours post-bite.^[46] Additionally, details on the cat's health status, including vaccination history against rabies and any signs of illness, help evaluate zoonotic risks.^[10] Physical examination focuses on the wound and surrounding tissues to identify early infection or complications. Cat bites commonly present as small, deep punctures, often on the hands or extremities, with assessment revealing depth, location relative to joints or bones, and any foreign material like tooth fragments.^[1] Clinicians evaluate for neurovascular integrity, range of motion, and signs of deeper involvement, such as tendon or joint penetration, while checking for systemic indicators like fever or lymphadenopathy.^[46] Diagnostic criteria for infection rely on clinical signs aligned with Infectious Diseases Society of America (IDSA) guidelines for skin and soft tissue infections (SSTIs), noting that infected cat bites are often purulent and involve polymicrobial inoculation from oral flora.^[47] Established infection manifests as localized erythema, warmth, swelling, tenderness, or purulent drainage, often progressing rapidly in cat bites compared to other wounds; systemic symptoms like fever or chills suggest complicated SSTI.^[1] Non-infected bites may show minimal inflammation initially, but high-risk features—such as hand involvement or delayed presentation—warrant presumptive diagnosis and prophylaxis.^[10] Differential diagnosis distinguishes cat bites from other injuries based on history and exam findings. Unlike dog bites, which produce broader lacerations or crush injuries, cat bites feature narrow punctures prone to abscess formation.^[1] Human bites, often polymicrobial with Eikenella, differ in context (e.g., altercations) and flora, while non-infectious trauma like simple punctures lacks the rapid inflammatory response or animal exposure history.^[46] Other mimics include cellulitis from non-bite sources or arthropod stings, ruled out by absence of puncture marks and zoonotic context.^[10] Clinical scoring systems aid in stratifying infection risk and severity, though none are bite-specific; tools for SSTIs, such as those assessing purulence, systemic toxicity, and comorbidities per IDSA frameworks, guide decisions on escalation beyond clinical judgment.^[47]

Laboratory and Imaging Tests

Laboratory and imaging tests play a supportive role in confirming infection or complications following cat bites, particularly when clinical suspicion arises from history and examination. Blood tests are commonly employed to evaluate systemic involvement. A complete blood count (CBC) is performed to detect leukocytosis, which indicates an active infection, with elevated white blood cell counts often observed in cases of bacterial invasion.^[1] Inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are measured to assess the degree of inflammation.^[1] In instances of suspected systemic spread, such as sepsis, blood cultures are obtained to identify bacteremia, though they may yield positive results in only a subset of cases due to prior antibiotic administration or fastidious organisms.^[1] Wound cultures are essential for identifying the causative pathogens in infected cat bites, guiding targeted antimicrobial therapy. Swabbing techniques involve using a standard cotton swab for open lacerations or needle aspiration for abscesses, ideally performed after initial wound cleaning to avoid contamination from skin flora; swabs are rotated over the wound base for optimal yield.^[26] Cultures from infected cat bite wounds frequently isolate polymicrobial flora, with Pasteurella species, particularly Pasteurella multocida, recovered in approximately 70% of cases, underscoring its prevalence in feline oral microbiota.^[48] Imaging modalities are utilized to detect structural complications or deep-seated infections. Plain X-rays are the initial imaging choice to evaluate for fractures, retained foreign bodies like tooth fragments, or early signs of osteomyelitis, such as periosteal reaction or bone erosion, especially in hand bites where deep penetration is common.^[1] Ultrasound is effective for identifying superficial abscesses or fluid collections, offering real-time guidance for drainage procedures without radiation exposure.^[1] For suspected deep tissue involvement or confirmed osteomyelitis, magnetic resonance imaging (MRI) provides superior soft tissue contrast, revealing bone marrow edema, abscesses, or tenosynovitis with high sensitivity.^[1]^[49] Serologic testing is indicated for specific pathogens when clinical features suggest atypical infections. For Bartonella henselae, implicated in cat scratch disease that can complicate bites, indirect immunofluorescence assay or enzyme-linked immunosorbent assay detects antibodies, with titers greater than 1:256 supporting diagnosis in the presence of exposure history.^[50] Rabies evaluation focuses on post-exposure protocols rather than routine patient serology; if the cat's status is unknown, immediate risk assessment leads to prophylaxis including wound care, rabies immune globulin, and vaccine series, per CDC guidelines, as serologic testing in humans is typically reserved for confirming immunity post-vaccination.^[51]

Management and Treatment

Wound Care and Initial Interventions

Upon sustaining a cat bite, immediate wound care is essential to minimize infection risk and promote healing. The wound should be thoroughly cleaned as soon as possible by washing with soap and running water for at least 15-20 minutes to reduce bacterial contamination from the cat's oral flora.^[52]^[53] Following initial washing, high-pressure irrigation using a 20- to 30-mL syringe filled with normal saline or sterile water is recommended to flush out debris and devitalized tissue, aiming for a pressure of approximately 7 psi to effectively remove pathogens without causing further tissue damage.^[1]^[52] Debridement involves the careful removal of any necrotic or devitalized tissue to prevent bacterial proliferation in the wound bed, particularly important for puncture wounds common in cat bites due to their deep, narrow nature that traps bacteria.^[1]^[52] Primary closure of cat bite wounds, especially punctures, should be avoided to allow drainage and reduce the high infection rate, which can reach up to 30-50% if closed prematurely; instead, wounds are typically left open or loosely packed with sterile gauze.^[1]^[52] For bites to the hand, which account for a significant portion of cat bite injuries and carry elevated complication risks, immobilization using a bulky dressing or splint in the position of function (slight wrist extension) is advised to limit motion and facilitate healing.^[54]^[1] Concurrently, elevation of the affected limb above heart level is crucial to reduce edema and swelling, particularly in the first 24-48 hours post-injury.^[54]^[52] Pain management begins with local anesthetics, such as lidocaine infiltration around the wound edges, to facilitate irrigation and debridement without excessive discomfort.^[1] Non-opioid analgesics, including nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, are preferred for ongoing pain control due to their anti-inflammatory properties that also help mitigate swelling.^[1] Tetanus prophylaxis is guided by the patient's vaccination history and the wound's classification as tetanus-prone (dirty, due to contamination with saliva and tissue damage). For individuals with a complete primary series whose last booster was more than 5 years ago, a tetanus toxoid-containing vaccine (Td or Tdap) should be administered; if the history is unknown or incomplete, both the vaccine and tetanus immune globulin (TIG) at 250 IU intramuscularly are indicated.^[55]^[1] No tetanus prophylaxis is needed if the last dose was within 5 years and the primary series is complete.^[55] Rabies post-exposure prophylaxis (PEP) should be assessed based on the cat's status, local rabies epidemiology, and exposure circumstances. For domestic cats that can be observed for 10 days and remain healthy, PEP is typically not required. However, if the cat is stray, wild, unvaccinated, or unavailable for observation, or if the bite is severe (e.g., to head/neck), initiate PEP immediately, which includes thorough wound cleansing (as above), administration of human rabies immune globulin (HRIG, 20 IU/kg, infiltrated around the wound if possible) on day 0, and a four-dose rabies vaccine series (days 0, 3, 7, 14) for immunocompetent individuals. Consult local health authorities for risk determination; PEP can be discontinued if the cat is confirmed rabies-negative during observation.^[56]^[57]

Antibiotic Therapy and Surgical Options

Antibiotic therapy is a cornerstone of managing cat bite wounds, particularly given the high risk of infection from pathogens such as Pasteurella multocida. Empiric oral antibiotics are recommended for prophylaxis in all cat bites that penetrate the skin, with amoxicillin-clavulanate (Augmentin) as the first-line agent due to its broad coverage of aerobic and anaerobic bacteria commonly associated with these injuries.^[52]^[1]^[54] For patients with penicillin allergies, alternatives include doxycycline monotherapy or a combination of trimethoprim-sulfamethoxazole and metronidazole to ensure anaerobic coverage.^[1]^[54] Prophylactic therapy typically lasts 3 to 5 days, while treatment for established infections extends to 10 to 14 days, guided by clinical response and culture results if available.^[52]^[54] Monitoring involves reassessment within 48 hours for signs of worsening infection, such as increased erythema, fever, or lymphadenopathy; failure to improve may necessitate switching to intravenous antibiotics like ampicillin-sulbactam for severe cases involving systemic symptoms, deep tissue involvement, or immunocompromised hosts.^[52]^[1] Guidelines from the Infectious Diseases Society of America (IDSA, 2014) emphasize these regimens amid rising antimicrobial resistance patterns, particularly in Pasteurella species, advocating for culture-directed therapy when possible.^[52]^[58] Surgical interventions are indicated for complications such as abscess formation or deep infections, where simple drainage and debridement can prevent progression to osteomyelitis or septic arthritis. Incision and drainage is performed for localized pus collections, often under local anesthesia, followed by thorough irrigation to remove necrotic debris.^[1]^[54] For puncture wounds, especially on the hands, surgical exploration is essential to assess for tendon, joint, or neurovascular damage, with debridement of devitalized tissue to reduce infection risk; primary closure is generally avoided in favor of healing by secondary intention, per IDSA recommendations.^[52]^[1] In severe cases with systemic involvement, hospitalization for operative intervention may be required, with follow-up imaging to monitor for complications.^[54]

Prevention and Public Health

Personal Prevention Strategies

To prevent cat bites, individuals should adopt behavioral strategies that minimize interactions likely to provoke a cat's defensive response. Avoid handling cats that appear stressed, such as those with dilated pupils, flattened ears, or a twitching tail, as these are signs of potential aggression. Supervise children closely around cats, teaching them to pet gently and avoid pulling tails or ears, since young children are at higher risk due to rough play. When working in animal care settings, such as veterinary clinics or shelters, wear thick gloves to protect hands from unexpected bites during handling.^[59]^[60]^[61] At home, several measures can reduce the likelihood of bites from pet cats. Keep cats' nails trimmed regularly to lessen the severity of any scratches or bites that occur during play. Spaying or neutering cats significantly decreases aggression, territorial marking, and roaming behaviors that lead to conflicts, with studies showing reduced fighting and bite incidents in altered cats. Ensure all pet cats are up to date on rabies vaccinations, as this not only protects against zoonotic transmission but also encourages responsible ownership that correlates with calmer pet behavior. If a cat shows persistent aggression, consult a veterinarian to rule out underlying health issues like pain or illness.^[59]^[62] Public education on cat bite risks has grown since the 2010s through initiatives by health organizations, focusing on recognizing warning signs, promoting pet alterations, and stressing prompt wound care to empower individuals in preventing complications.^[63]

Epidemiological Trends and Statistics

Cat bites represent a notable public health concern, with approximately 66,000 emergency department visits occurring annually in the United States.^[2] Globally, they account for 2–50% of all animal bite injuries, second only to dog bites in frequency.^[2] In low- and middle-income countries, particularly in Asia, incidence is elevated due to large populations of stray cats in urban areas, where cats can comprise up to 50% of reported bites in some settings.^[64] Demographically, cat bites disproportionately affect females, who represent about 60% of victims, with a female-to-male ratio of approximately 2:1.^[65] Incidence rates of cat bites increase with age, peaking among adults aged 80 years and older, who experience the highest rates (up to 33.6 per 100,000 person-years in studied populations). Children are at greater risk from dog bites than cat bites.^[66] Urban-rural disparities are evident; in some studies, cat bites are more frequent in urban areas, while overall animal bites may show higher rural reporting linked to stray animal control issues.^[67] Post-2020 trends reflect a surge in pet adoptions during the COVID-19 pandemic, with cat adoptions rising by 6 percentage points compared to 2019 levels, potentially contributing to increased bite incidents.^[68] Infection rates for cat bites are high, ranging from 28% to 80%, with hospitalization required in about 30% of cases involving hand wounds due to severe complications.^[69] Comparatively, morbidity from cat bites is higher in low-resource settings, where delayed access to antibiotics and wound management exacerbates outcomes like sepsis.^[2] As of 2025, zoonotic reporting has intensified, with emerging rabies cases in cats noted across Asia and Africa, prompting enhanced surveillance in regions with unmanaged stray populations. For example, in 2025, two of four rabies deaths in Sarawak, Malaysia, were attributed to cat bites or scratches, prompting discussions on cat licensing.^[70]^[71]

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Pasteurella multocida infection: a differential retrospective study of ...
Mar 4, 2025 · Our study finds that regardless of what age, P. multocida is often infected by cat bites or scratches, which may be related to the fact that ...
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Molecular characterization of Pasteurella multocida from cats and ...
Mar 22, 2024 · The prevalence of P. multocida in cats was 29%. Among the isolates, the majority were capsular type A (96.5%) and type D (3.4%), with a ...3 Results · 3.4 Virulence Genes... · 4 Discussion<|separator|>
[34]
Antimicrobial Resistance in Pasteurella multocida Isolates ... - MDPI
In humans, P. multocida infections are mainly associated with bites or scratches caused by cats and dogs, although non-bite transmissions also occur [2,3]. The ...
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Vector-borne and other pathogens of potential relevance ... - NIH
Nov 8, 2022 · Sepsis caused by newly identified Capnocytophaga canis following cat bites: C. canis is the third candidate along with C. canimorsus and C ...
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Cat-Associated Zoonoses | Infectious Diseases - JAMA Network
Of the 297 cases of human plague reported in the United States between 1977 and 1998, 7.7% were attributed to cat transmission. Cats likely acquire infection ...
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Diseases Transmitted by Cats | Microbiology Spectrum - ASM Journals
Prevention of infection should be advocated for immunocompromised patients at risk for disease. They should be instructed not to change cat litter boxes or ...Missing: diabetes veterinary
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Animal Bites in Emergency Medicine - Medscape Reference
Aug 5, 2025 · Infections caused by cat bites generally develop faster than those caused by dog bites. The available literature on other mammalian bites is ...
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Toxoplasmosis not transmitted by cat bite, but high prevalence of ...
Toxoplasmosis not transmitted by cat bite, but high prevalence of antibodies to Toxoplasma gondii in patients bitten by their own cat. Scand J Infect Dis. 2010 ...
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Septic arthritis and osteomyelitis from a cat bite - PMC - NIH
A 39-year-old man with no prior history of underlying arthritis developed osteomyelitis and septic arthritis in his hand following a cat bite.
[41]
A rare case report of metacarpal osteomyelitis following a domestic ...
Osteomyelitis of the metacarpal bones following a cat bite is an exceedingly rare condition, with limited cases reported in the literature.
[42]
Septic Arthritis and Osteomyelitis Caused by Pasteurella multocida
Sep 19, 2019 · Most notably, it was important to elicit the history of a cat bite to include and consider Pasteurella multocida as a potential pathogen.
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https://pubmed.ncbi.nlm.nih.gov/1823783/
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Cat bite wounds: risk factors for infection - PubMed
The overall patient infection rate for those with cat "bites" was 15.6%. Factors associated with wound infections included older age (P less than . 001), ...
[45]
Cat bite infections of the hand: assessment of morbidity ... - PubMed
Results: Thirty percent (n = 57) of patients with cat bites to the hand were hospitalized. The average length of stay for these patients was 3.2 days.
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Review of psychological effects of dog bites in children - PMC - NIH
Jun 6, 2024 · The most common psychological consequences of dog bites in children were post-traumatic stress disorder, dog phobia, nightmares and symptoms of anxiety and ...
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Animal Bites in Emergency Medicine Clinical Presentation
Aug 5, 2025 · The history in patients with animal bites should include the following: Time and location of event. Type of animal and its status (eg, ...
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Skin and Soft Tissue Infections - IDSA
Jul 15, 2014 · The focus of this guideline is the diagnosis and appropriate treatment of diverse SSTIs ranging from minor superficial infections to life-threatening ...Recommendations (Abridged) · Introduction · Methodology · Full Recommendations
[49]
Cat bite wound infections: a prospective clinical and microbiological ...
Results: Seventy-nine episodes in 78 patients with infective cat bites were included. Pasteurella multocida was isolated in 70% of the patients; in addition ...
[50]
CAT BITE Antibiotic Prophylaxis for the Hand/Forearm (CATBITE ...
The median time to signs and symptoms of infection following a cat bite is typically short (approximately 12 hours). Direct healthcare costs associated with ...<|control11|><|separator|>
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Osteomyelitis following Domestic Animal Bites to the Hand - NIH
Nov 18, 2016 · Firstly, radiography is performed if presence of a foreign body or bone involvement is suspected [5,9,10]. As seen in our cases, osteomyelitis ...
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Cat-scratch Disease - AAFP
Jan 15, 2011 · Diagnosis is most often arrived at by obtaining a history of exposure to cats and a serologic test with high titers (greater than 1:256) of ...
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Rabies Post-exposure Prophylaxis Guidance - CDC
Jul 15, 2025 · Rabies PEP should be administered using a 5-dose vaccine regimen, which includes one dose of vaccine on days 0, 3, 7, 14, and 28.
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Animal bites (dogs, cats, and other mammals)
Nov 19, 2024 · Obtaining a history · Inspecting the wound · - Wound preparation · - Physical examination · Assessing for infection · - Onset of signs and ...
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Animal bites: First aid - Mayo Clinic
You notice increasing swelling, skin color changes, pain or oozing. These are signs of infection. You aren't sure whether the animal that bit you has rabies.
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Clinical Guidance for Wound Management to Prevent Tetanus - CDC
Jun 10, 2025 · Clean all wounds; Remove dirt or foreign material; Remove or debride necrotic material. Antibiotic prophylaxis against tetanus isn't recommended ...
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Bite Wounds | Red Book Online | American Academy of Pediatrics
Current guidelines from the Infectious Diseases Society of America (IDSA) state that primary wound closure is not recommended for most animal bite wounds.
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What To Do for a Cat Bite or Scratch
Mar 3, 2025 · Tips to prevent cat bites and scratches · Avoiding rough play, which can lead to cats being defensive · Keeping your cat's nails trimmed · Be ...
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Prevent Bite Wounds - HealthyChildren.org
Nov 21, 2015 · Teach your child to avoid contact with wild animals. · Never leave a young child alone with an animal. · Don't allow your child to tease a pet, ...Missing: personal strategies
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Zoonotic Exposures: Bites, Scratches, and Other Hazards - CDC
Apr 23, 2025 · Travelers should be aware that attacks by domestic animals (e.g., stray dogs and cats) are far more common than attacks by wildlife.Missing: scenarios household occupational
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Cat Neutering and Behavior | VCA Animal Hospitals
Some types of aggressive behavior may decrease following castration, while others will not. If your cat exhibits aggressive behavior, consult with your ...
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Rabies Prevention and Control - CDC
Jul 1, 2025 · When immediate care is needed · Wash any wounds immediately with soap and water for 15 minutes to flush out any virus. · Talk with a healthcare or ...
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Animal bites - self-care Information | Mount Sinai - New York
Cat bites are less common but have a higher risk for infection. Cat teeth ... You should get medical attention within 24 hours for any bite that breaks the skin:.Wound Care · Possible Complications · When To Call The DoctorMissing: authoritative | Show results with:authoritative
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Animal Bites - CDPH - CA.gov
Sep 20, 2024 · Get down to a cat's level and wait for the cat to come to you before you try to pet it. · Pet cats gently and avoid loud voices or other noises.Missing: strategies | Show results with:strategies
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Demographic, temporal, and spatial analysis of human animal bite ...
Jun 9, 2025 · Dogs accounted for 76–94% of reported bite cases in low- and middle-income countries, while cats accounted for 2–50% globally [11]. In urban ...
[66]
Animal and Human Bite Wounds - PMC - NIH
The risk of infection depends on the nature and site of the wound as well ... Cat bites on the hand are at high risk of infection. Streptococci can be ...
[67]
Clinical and epidemiologic features of persons accessing ...
Feb 22, 2023 · The average annual incidence of dog bites was highest in children aged < 10 years and males, while that of cat bites was highest in adults aged ≥ 80 years and ...
[68]
Epidemiological and demographic study of acute animal biting
Regarding geographical distribution, the largest number of acute animal bites (164 cases or 53.1% of the total) happened among rural people, 111 cases (35.9%) ...
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https://pmc.ncbi.nlm.nih.gov/articles/PMC2819935/
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When your best friend bites: A note on dog and cat bites - PMC - NIH
The appropriate treatment for dog and cat bites consists of the following: inquiring about the status of tetanus immunization and providing booster doses, as ...
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Rabies in Cats—An Emerging Public Health Issue - PMC
Oct 19, 2024 · Lack of public awareness about rabies vaccination for domestic cats, difficulties in including cats in vaccination campaigns, and insufficient ...