Title: Cat bite

{{Infobox medical condition (new)
| name            = Cat bite
| synonyms        =
| image           = Cat wounded in a fight.jpg
| caption         = A cat wounded from the bite of another cat
| pronounce       =
| field           = [[Emergency medicine]], [[plastic surgery]], [[pediatrics]], [[veterinary medicine]]
| geneReviewsID   =
| symptoms        =
| complications   =
| onset           =
| duration        =
| types           =
| causes          =
| risks           =
| diagnosis       =
| differential    =
| prevention      =
| treatment       =
| medication      =
| prognosis       =
| frequency       =
| deaths          =
}}
'''Cat bites''' are bites inflicted upon humans, other cats, and other animals by the domestic [[cat]] (''Felis catus'').&lt;ref name=&quot;MSW3fc&quot;&gt;{{MSW3 Carnivora|id=14000031 |pages=534–535 |heading=Species ''Felis catus''}}&lt;/ref&gt;&lt;ref name=&quot;ITIS F.c.&quot;&gt;{{cite web |url= https://www.itis.gov/servlet/SingleRpt/SingleRpt?search_topic=TSN&amp;search_value=183798 |title=ITIS Standard Report Page: Felis catus |work=ITIS Online Database |year=2011 |publisher=[[Integrated Taxonomic Information System]] |location=Reston, Virginia |access-date=14 December 2011}}&lt;/ref&gt; Data from the [[United States]] show that cat bites represent between 5–15% of all animal bites inflicted to humans,&lt;ref name=&quot;:0&quot;&gt;{{Cite journal|last1=Aziz|first1=Hassan|last2=Rhee|first2=Peter|last3=Pandit|first3=Viraj|last4=Tang|first4=Andrew|last5=Gries|first5=Lynn|last6=Joseph|first6=Bellal|date=2015-03-01|title=The current concepts in management of animal (dog, cat, snake, scorpion) and human bite wounds|journal=Journal of Trauma and Acute Care Surgery|language=ENGLISH|volume=78|issue=3|pages=641–648|doi=10.1097/TA.0000000000000531|issn=2163-0755|pmid=25710440|s2cid=27833551}}&lt;/ref&gt;&lt;ref name=&quot;:1&quot;&gt;{{Cite journal|last1=Olcott|first1=Jessica L.|last2=Bula-Rudas|first2=Fernando J.|date=2018-10-01|title=Human and Animal Bites|url=https://pedsinreview.aappublications.org/content/39/10/490|journal=Pediatrics in Review|volume=39|issue=10|pages=490–500|doi=10.1542/pir.2017-0212|issn=0191-9601|pmid=30275032|s2cid=52898850|url-access=subscription}}&lt;/ref&gt; but it has been argued that this figure could be the consequence of under-reporting as bites made by cats are considered by some to be unimportant.&lt;ref name=&quot;:4&quot; /&gt;&lt;ref name=&quot;:2&quot;&gt;{{Cite journal|last1=Philipsen|first1=T. E. J.|last2=Molderez|first2=C.|last3=Gys|first3=T.|date=2006-01-01|title=Cat And Dog Bites. What To Do?|journal=Acta Chirurgica Belgica|volume=106|issue=6|pages=692–695|doi=10.1080/00015458.2006.11679983|pmid=17290697|s2cid=38532972|issn=0001-5458}}&lt;/ref&gt; Though uncommon, cat bites can sometimes transmit [[rabies]], cause health complications, and even, though very rarely, lead to death.&lt;ref name=&quot;GurryCampion2017&quot;&gt;{{cite journal|last1=Gurry|first1=Greta A.|last2=Campion|first2=Veronique|last3=Premawardena|first3=Chamath|last4=Woolley|first4=Ian|last5=Shortt|first5=Jake|last6=Bowden|first6=Donald K.|last7=Kaplan|first7=Zane|last8=Dendle|first8=Claire|title=High rates of potentially infectious exposures between immunocompromised patients and their companion animals: an unmet need for education|journal=Internal Medicine Journal|volume=47|issue=3|year=2017|pages=333–335|issn=1444-0903|doi=10.1111/imj.13361|pmid=28260250|hdl=11343/292579 |s2cid=34956653|hdl-access=free}}&lt;/ref&gt;&lt;ref name = kidshealth&gt;{{Cite web|url=https://kidshealth.org/en/parents/animal-bites-sheet.html?WT.ac=p-ra|title=First Aid: Animal Bites|publisher = The Nemours Foundation|access-date=2017-06-18 | date = 2017}}&lt;/ref&gt;&lt;!--[[Animal bite]], [[Human interaction with cats]], [[Cat-scratch disease]], [[Cat]], [[Cat communication]], [[Cat health]], [[Pasteurellosis]], [[Bergeyella]], http://emedicine.medscape.com/article/768875-treatment#d10 --&gt;

==Signs and symptoms==
Cat bites are usually considered minor injuries but can result in serious [[infection]] and cause [[rabies]] if inflicted by a [[rabid cat]].&lt;ref name=&quot;Man2017&quot; /&gt; Common symptoms include [[pain]] and [[Swelling (medical)|swelling]] around the affected area.&lt;ref name=&quot;:0&quot;/&gt; Sometimes, direct tissue damage from the cat bite can impair mobility or cause [[tenosynovitis]] or [[Septic arthritis|arthritis]].&lt;ref&gt;{{Cite journal|last1=Jorup|first1=Christina|last2=Wretlind|first2=Bengt|last3=Settergren|first3=Bo|last4=Sandstedt|first4=Karin|last5=Ekblom|first5=Anna Gerber|last6=Cars|first6=Björn|last7=Farra|first7=Anna|last8=Westling|first8=Katarina|date=2006-12-01|title=Cat bite wound infections: A prospective clinical and microbiological study at three emergency wards in Stockholm, Sweden|url=https://www.journalofinfection.com/article/S0163-4453(06)00005-3/abstract|journal=Journal of Infection|language=English|volume=53|issue=6|pages=403–407|doi=10.1016/j.jinf.2006.01.001|issn=0163-4453|pmid=16483663|url-access=subscription}}&lt;/ref&gt; In these cases, surgical consultation is needed to assess severity.&lt;ref name=&quot;:0&quot;/&gt;&lt;ref name=&quot;:1&quot;/&gt; Some unusual complications, like [[Deep vein thrombosis|deep-vein thrombosis]],&lt;ref name=&quot;:4&quot;&gt;{{Cite journal|last1=G&amp;shy;arrama-Conzuelo|first1=F|last2=Gutierrez-Castillo|first2=A|date=2019-06-17|title=Cathrombosis: Deep Vein Thrombosis After a Cat Bite - A Case Report|journal=Cureus|volume=11|issue=6|article-number=e4924|doi=10.7759/cureus.4924|doi-access=free|pmid=31423400|pmc=6692098}}&lt;/ref&gt; [[subcutaneous emphysema]]&lt;ref name=&quot;:3&quot;&gt;{{Cite journal|last1=Wagner|first1=Brian K.|last2=Martone|first2=Jeffrey D.|last3=Conte|first3=Harry|last4=Hill|first4=Melissa|last5=Kusan|first5=Karuna|date=September 2006|title=Complications of a Cat Bite|journal=Journal of the American Podiatric Medical Association|volume=96|issue=5|pages=455–457|doi=10.7547/0960455|pmid=16988179|issn=8750-7315}}&lt;/ref&gt; and [[Fetal distress|fetal tachycardia]]&lt;ref name=&quot;:3&quot;/&gt; have been described. Some of the infections acquired from a cat bite can be acquired otherwise, like [[Plague (disease)|plague]].&lt;ref name=&quot;GageDennis2000&quot;&gt;{{cite journal|last1=Gage|first1=K. L.|last2=Dennis|first2=D. T.|last3=Orloski|first3=K. A.|last4=Ettestad|first4=P.|last5=Brown|first5=T. L.|last6=Reynolds|first6=P. J.|last7=Pape|first7=W. J.|last8=Fritz|first8=C. L.|last9=Carter|first9=L. G.|last10=Stein|first10=J. D.|title=Cases of Cat-Associated Human Plague in the Western US, 1977-1998|journal=Clinical Infectious Diseases|volume=30|issue=6|year=2000|pages=893–900|issn=1058-4838|doi=10.1086/313804|pmid=10852811|doi-access=free}}&lt;/ref&gt;

==Infections==
[[File:Ancylostoma braziliense mouth parts CDC PHIL ID1375.jpg| thumb|''Ancylostoma braziliense'' mouthparts]]
{{See|Feline zoonosis}}
The resident [[Microbiota|flora]] in the mouth of the domestic cat includes ''[[Pasteurella]]'', ''[[Staph]]'', ''[[Bartonella]]'', ''[[Globicatella]]''&lt;ref&gt;[https://www.independent.co.uk/news/science/cat-bite-infection-nhs-treatment-b2389974.html UK man bitten by cat contracts previously unknown and 'extensive' bacterial infection]&lt;/ref&gt; and ''[[Streptococcus]]'' species.&lt;ref name = Man2017&gt;{{cite web |last1 = Maniscalco |first1 =K | last2 = Edens |first2 =MA |title = Animal Bites | date = April 20, 2017 |access-date = June 17, 2017 | publisher = National Center for Biotechnology Information, U.S. National Library of Medicine |pmid =28613602 | url = https://www.ncbi.nlm.nih.gov/books/NBK430852/}}&lt;/ref&gt; Bites from cats develop infections more frequently than [[dog bite|bites from dogs]].&lt;ref name=&quot;:2&quot;/&gt; The teeth of a cat are sharp, pointed and can cause deep wounds. After a cat bite, the skin usually closes rapidly over the bite and may trap microorganisms.&lt;ref&gt;{{cite web|url=http://www.assh.org/handcare/hand-arm-injuries/animal-bites-treatment|title=Animal Bites|publisher=American Society for Surgery of the Hand|date=2017|website=Handcare.org|access-date=18 June 2017|archive-url=https://web.archive.org/web/20170728015622/http://www.assh.org/handcare/hand-arm-injuries/animal-bites-treatment|archive-date=28 July 2017}}&lt;/ref&gt;&lt;ref name=&quot;kidshealth&quot;/&gt;
The bite from a cat can infect a person with:
* [[Cat-scratch disease]], caused by the [[bacterium]] ''[[Bartonella henselae]]''&lt;ref name=&quot;kidshealth&quot;/&gt;&lt;ref name = med&gt;{{ cite web | url =https://medlineplus.gov/ency/imagepages/8989.htm | publisher = U.S. National Library of Medicine | access-date = June 17, 2017 | date = September 10, 2015 | title = Cat scratch disease}}&lt;/ref&gt;
** Cat-scratch disease is a bacterial disease that people may get after being bitten or scratched by a cat. About 40% of cats carry the bacteria at some time in their mouths, although [[kitten]]s younger than one year of age are more likely to have it.&lt;ref name=&quot;RijksCito2016&quot;&gt;{{cite journal|last1=Rijks|first1=J. M.|last2=Cito|first2=F.|last3=Cunningham|first3=A. A.|last4=Rantsios|first4=A.T.|last5=Giovannini|first5=A.|title=Disease Risk Assessments Involving Companion Animals: an Overview for 15 Selected Pathogens Taking a European Perspective|journal=Journal of Comparative Pathology|volume=155|issue=1|year=2016|pages=S75–S97|issn=0021-9975|doi=10.1016/j.jcpa.2015.08.003|pmid=26422413|doi-access=free}}&lt;/ref&gt; Most cats with this infection show no signs of illness.
* [[Hookworm infection|Hookworm]], ''[[Ancylostoma tubaeforme]]'', ''[[Ancylostoma braziliense]]'', and ''[[Uncinaria stenocephala]]''
* ''[[Capnocytophaga canimorsus]]''&lt;ref&gt;Joanna Zajkowska, Monika Król, Daniel Falkowski, Norina Syed, Anna Kamieńska. [https://www.ncbi.nlm.nih.gov/pubmed/27837588 &quot;Capnocytophaga canimorsus – An Underestimated Danger After Dog or Cat Bite – Review of the Literature&quot;], Przegl Epidemiol. 2016;70(2):289-295. n.d.&lt;/ref&gt;
* [[Pasteurellosis]] caused by the bacterial genus ''[[Pasteurella]]''&lt;ref name=&quot;LloretEgberink2013&quot;&gt;{{cite journal|last1=Lloret|first1=Albert|last2=Egberink|first2=Herman|last3=Addie|first3=Diane|last4=Belák|first4=Sándor|last5=Boucraut-Baralon|first5=Corine|last6=Frymus|first6=Tadeusz|last7=Gruffydd-Jones|first7=Tim|last8=Hartmann|first8=Katrin|last9=Hosie|first9=Margaret J|last10=Lutz|first10=Hans|last11=Marsilio|first11=Fulvio|last12=Möstl|first12=Karin|last13=Pennisi|first13=Maria Grazia|last14=Radford|first14=Alan D|last15=Thiry|first15=Etienne|last16=Truyen|first16=Uwe|last17=Horzinek|first17=Marian C|title=Pasteurella Multocida Infection in Cats|journal=Journal of Feline Medicine and Surgery|volume=15|issue=7|year=2013|pages=570–572|issn=1098-612X|doi=10.1177/1098612X13489215|pmid=23813817|pmc=11148962 |hdl=2268/187998 |s2cid=10682140|hdl-access=free}}&lt;/ref&gt;&lt;ref name=&quot;Chomel2014&quot;&gt;{{cite journal|last1=Chomel|first1=Bruno|title=Emerging and Re-Emerging Zoonoses of Dogs and Cats|journal=Animals|volume=4|issue=3|year=2014|pages=434–445|issn=2076-2615|doi=10.3390/ani4030434|pmid=26480316|pmc=4494318|doi-access=free}}&lt;/ref&gt;
** Pasteurellosis is a bacterial disease associated with [[animal bite]]s and scratches. ''[[Pasteurella|Pasteurella spp]]'' is a normal bacterium that also lives in the mouths of healthy cats. The [[nonpathogenic organisms|bacteria]] do not typically make cats sick; however, cats can develop abscesses or skin infections in places where they were scratched or bitten by another animal.
In people, pasteurellosis causes painful wounds and skin infections. In severe cases, it can cause widespread infection and might even affect the nervous system.
* [[Rabies]], a fatal neurologic disease in animals and people, is caused by a [[virus]]. [[Animal]]s and people are most commonly infected through bites from rabid animals. Infected cats may have a variety of signs, but most often have sudden behavioral changes and progressive paralysis.&lt;ref name=&quot;auto&quot;&gt;https://www.cdc.gov/healthypets/pets/cats.html {{CDC}}&lt;/ref&gt;

==Diagnosis==
The diagnosis is aided by obtaining a history of the circumstances surrounding the bite. The time the bite was experienced, the location of the bite, and examination of the bite are noted. The person may have drainage from the site of the bite. They may also be [[febrile]], and [[Swelling (medical)|swelling]] around the wound may occur. Because the wound from the bite may heal too quickly over the punctures, it may need to be opened and explored. [[Hydrogen peroxide]] may be used at home to reopen the wound, with pressure being applied around the wound to drain any abscesses. For deep wounds, this process may need to be repeated. At a hospital, the patient may request that the site be anesthetized before exploration. Neurovascular status is assessed. Immune status may determine treatment, as does the presence of transplanted tissue or organs, rheumatic disease, [[Diabetes mellitus|diabetes]], [[HIV/AIDS]], and [[sickle cell disease]]. Swollen [[lymph node]]s and red streaks radiating upward may be evident.&lt;ref name = AAP/&gt;&lt;ref name=&quot;med&quot;/&gt;&lt;ref name = Man2017/&gt;

The diagnosis of a cat with [[Rabies in animals|rabies]] is usually evident by observing the cat. Cats with rabies may also appear restless, pant, and attack other animals, people, or objects. Animals with rabies typically die within a few days of appearing sick.  Vaccination of the cat can prevent rabies from being transmitted by the cat through a bite. If the cat is suspected of being infected with rabies, the person bitten will immediately begin treatment with [[rabies vaccine]].&lt;ref name=&quot;auto&quot;/&gt;

==Prevention==
&lt;!--(if the section only discusses secondary prevention it should follow the treatment section)--&gt;
Cat bites can often be prevented by:
* avoiding cats
* instructing children not to tease cats or other pets&lt;ref name=&quot;kidshealth.org&quot;&gt;{{Cite web | url=https://kidshealth.org/en/parents/animal-bites-sheet.html?WT.ac=p-ra | title=First Aid: Animal Bites (for Parents) - KidsHealth}}&lt;/ref&gt;
* being cautious with unfamiliar cats
* approaching cats with care, even if they appear to be friendly
* avoiding rough play with cats and kittens.

Rough play is perceived as aggressive. This will lead to the cat being defensive when approached by people. Preventing cat bites includes not provoking the cat. If a cat is reactive, handle it with care, being careful not to trigger any fear or aggression responses. The cat may bite its handler or someone nearby to defend itself.

==Treatment==
The first step in treatment includes washing and then irrigating the bite wound with water and isopropyl alcohol.&lt;ref name=WHO2013&gt;{{cite web|title=Animal bites Fact sheet N°373|url=https://www.who.int/mediacentre/factsheets/fs373/en/|work=World Health Organization|access-date=June 17, 2017|date=February 2013}}&lt;/ref&gt;&lt;ref&gt;https://www.cdc.gov/healthypets/pets/cats.html#what-to-do {{CDC}}&lt;/ref&gt;&lt;ref name = Man2017/&gt; Often, a tetanus shot is prescribed.&lt;ref name=&quot;kidshealth&quot;/&gt; If a cat that has bitten another cat or animal and appears to be ill, the cat would benefit from an assessment and possible treatment by a [[Veterinary physician|veterinarian]]. If the wound has a low risk of being infected, it is sometimes only sutured.&lt;ref name=&quot;WHO2013&quot;/&gt; A person who has been bitten by a cat with rabies will need specialized treatment. Resulting infections from cat bites can be prevented by immediately washing wounds with soap and warm water.
Seek medical attention if the cat has not been vaccinated against rabies.&lt;ref name=&quot;kidshealth.org&quot;/&gt; If a cat has bitten someone, and there is no evidence that the cat has been vaccinated against rabies, the person will be treated for rabies infection.&lt;ref name=&quot;auto&quot;/&gt;
&lt;!-- ==Outcomes or Prognosis== --&gt;

==Epidemiology==
{{Globalize|date=December 2017}}
Over 400,000 cat bites are reported each year in the US, though the actual number of bites is much higher since many such bites are under-reported.&lt;ref name = AAP&gt;{{cite web| publisher = American Academy of Pediatrics |  access-date = June 17, 2017 | date = 2017 | title = Prevent Bite Wounds | url = https://www.healthychildren.org/English/health-issues/conditions/prevention/Pages/Prevent-Bite-Wounds.aspx }}&lt;/ref&gt; 40 million households in the United States have domestic cats.&lt;ref&gt;https://www.cdc.gov/rabies/pets/index.html {{CDC}}&lt;/ref&gt; Data on the number of people bitten or scratched by cats is limited because most of these incidents are not reported; however, 20–80% of cat bites and scratches become infected.&lt;ref name=&quot;LloretEgberink2013&quot;/&gt; Cat-scratch disease or cat-scratch fever, an infection that causes fever and swollen lymph nodes, can develop from cat scratches, even if they only break the surface of the skin. Based on reports of people treated for cat bites at hospitals, women are most likely to be victims of cat bites and scratches.&lt;ref name=&quot;auto&quot;/&gt; Because of their smaller build, children are more likely to be bitten on their head, neck and face. Adults are more likely to be bitten on the hands and arms.&lt;ref name = Man2017/&gt; Those who are immunocompromised are more susceptible to infection from a cat bite.&lt;ref name=&quot;kidshealth&quot;/&gt;

Data show that cat bites are more common found in [[Woman|women]] than in [[Man|men]],&lt;ref name=&quot;:0&quot;/&gt; and in [[Old age|older adults]], particularly those over 75 years old.&lt;ref name=&quot;:0&quot;/&gt; Cat bites are more frequent in the [[morning]]s,&lt;ref name=&quot;:0&quot;/&gt; during [[Spring (season)|spring]] and [[summer]].&lt;ref name=&quot;:2&quot;/&gt; The most commonly affected [[human body]] part are the [[arm]]s.&lt;ref name=&quot;:0&quot;/&gt; Attackers are usually [[Feral cat|stray females]].&lt;ref name=&quot;:2&quot;/&gt;

==See also==

* [[Coyote attacks on humans]]
* [[Dog bite]]
* [[Rabies]]
* [[Wolf attacks on humans]]

==References==
{{Reflist}}

== External links ==
* [https://medlineplus.gov/ency/patientinstructions/000734.htm Self care for animal bites]

{{Medical resources
|  DiseasesDB      =
|  ICD10           = {{ICD10|W55.01XA}}
|  ICD9            =
|  OMIM            =
|  GeneReviewsName =
|  MedlinePlus = 000888
|  eMedicineSubj = emerg
|  eMedicineTopic =
|  MeshID =
}}
{{Animal bites and stings | state = collapsed}}

[[Category:Animal bites]]
[[Category:Cats]]
[[Category:Infectious diseases]]
[[Category:Parasites of cats]]
[[Category:Cat diseases]]
[[Category:Zoonoses]]
[[Category:Felidae attacks|*]]