II. Epidemiology

  1. Accounts for 5-10% of Animal Bites in U.S. (400,000 per year)
  2. High infection rate (50%)
  3. Bites are most common in adult women
  4. Bites are often reported as provoked
  5. Typically involves extremities

III. Pathophysiology

  1. Long slender fangs penetrate easily to deeper structures
    1. Risk of significant deep space infection, while the surface appears relatively benign
  2. Wound types
    1. Puncture Wounds (57-86%)
    2. Superficial abrasions (9-25%)
    3. Lacerations (5-17%)

IV. Complications

  1. Cat Scratch Disease (Bartonella species)
  2. Infected Cat Bite
    1. Pasteurella (53-80% of infections)
      1. Pasteurella multocida is most common cause
      2. Rapidly developing (<24 hours, with signs of infection as early as 3 hours after bite)
      3. Intense inflammation
      4. Possible bone, joint, or tendon involvement
    2. Other common aerobic infections
      1. Staphylococcus
      2. Streptococcus
    3. Other common anaerobic infections
      1. Fusobacterium
      2. Bacteroides
      3. Prevotella
      4. Porphyromonas
      5. Propionibacterium
    4. Other rare infections
      1. Tularemia
      2. Sporotrichosis

V. Management

  1. See Animal Bite for irrigation and general management
  2. Update Tetanus Vaccination as needed
  3. Antibiotic coverage
    1. See Infected Animal Bite
    2. Similar antibiotics as for Dog Bite Infection
    3. All Cat Bites should receive antibiotics
    4. Amoxicillin-clavulanate (Augmentin) or second-generation Cephalosporin
  4. Confirm cat has up to date Vaccinations including Rabies
    1. Start Rabies Prophylaxis if Rabies status cannot be confirmed
  5. DO NOT close punctures or Lacerations over 1-2 cm
    1. Impossible to properly cleaned
  6. Cosmetically important wounds < 1-2 cm
    1. Delayed primary closure

VI. References

  1. Cowling and House (2017) Crit Dec Emerg Med 31(5): 15-20
  2. Shivaprakash and Vezzetti (2022) Crit Dec Emerg Med 36(2): 3-10
  3. Presutti (1997) Postgrad Med 101(4): 243-54 [PubMed]

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