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Statistics show that up to 80% of cat bite wounds become infected. This is because cats have sharp, needle-like teeth that can cause deep puncture wounds which are not always easy to clean, and do not bleed a lot to get the infectious saliva out. The cat’s oropharyngeal flora are the most likely source of infection, other sources being the victim’s commensal skin organisms, contaminants from the environment and the cat’s recent diet.
Cat scratch disease
Victims of cat bites and scratches are also at risk of developing cat scratch disease (CSD), caused by the Bartonella species which can also be transmitted via the lick of a young cat. The typical feature of the disease is prolonged enlargement and tenderness of lymph nodes. Mild CSD can be treated with 10 to 14 days of antibiotics. Rare complications are encephalitis, coma and pneumonia.
Although most cases of rabies in South Africa are of canine origin, rabies should still be kept in mind when assessing any cat bite wound.
Evaluation of the wound
In the initial evaluation of a bite the following points must be assessed:
Time since injury: Most infected bites present after 12 hours which tend to result in the rapid development of redness, pain and swelling in less than eight hours.
Type of injury: Swelling can mask infection.
Associated injuries: Vascular, nerve and soft tissue injuries must be assessed.
Associated diseases: Older patients, especially those with heart and kidney disease, diabetes and peripheral vascular diseases, may get serious complications even after the most minor bite.
Site of injury: Nose, eye and ear injuries may require admission. Bites on hands and arms require special attention as their structures are relatively poorly protected by soft tissue and serious damage can result.
Debridement: Full thickness bites of hands or forearms should be explored and cleaned in an operating theatre where damage to cartilage, bones and nerves can be assessed and treated.
Closure of wounds: Even when cat bites are large, they should not be closed by suturing because of the high rate of infection.
Antibiotic treatment: It is highly recommended that you seek professional medical treatment for any cat bite.
Anti-tetanus measures: In the case of a minor wound, a booster dose of Tetanus Toxoid should be given if not immunised in the last 10 years.
Thanks to Dr J Frean of Wits University for his contribution.
Text: Dr Sonya Lindeque
The full article appears in the April 2015 issue of AnimalTalk.