Cats are cute, especially kittens. Many people have one or more cats as pets and let them sleep in their rooms at night. To paraphrase Clint Eastwood, you have to ask yourself: do you feel lucky, well, do you? You are asleep in bed, lying on your side when your cat jumps up and a claw causes a 2 inch laceration of your left upper eyelid. The wound bleeds profusely and as you are getting ready to go to work, you notice purple discoloration and swelling of the eyelid. What do you do? Time to see a physician.
The bacterium, Bartonella henselae, lives in the gut of fleas and can remain viable in flea feces for several days. Fleas transmit this bacteria to domestic and stray cats worldwide. Areas where fleas are endemic have higher rates of infested cats. A contaminated cat claw or bite can transmit this organism to humans causing cat scratch disease.
Most cat scratches are not serious and usually respond to symptomatic treatment by washing the wound with soap and water. Cat scratch infection of the eyelid, however, can rapidly progress to cellulitis around the eye, especially if the person is diabetic, or immunocompromised, e.g., HIV positive or alcoholic. Cat scratches can also infect lymph nodes around the head and neck and inside of the eye, as well.
In significant scratches, or a scratch on the eyelid, treatment includes antibiotics: Zithromax, azithromycin (Z-Pak) for 5 days, or rifampin, doxycycline, or ciprofloxacin. A laceration involving the upper eyelid may cut the muscle that allows the eyelid to move up-and-down. Microsurgical treatment by an ophthalmologist may be needed to prevent eyelid droop. Alternatively, if the wound does not involve the eyelid muscle, a plastic surgeon may be consulted about the need for sutures.
Clostridium tetani spores, which cause tetanus can be found in the soil and in the intestines and feces of cats and other household pets. Tetanus is usually acquired by a laceration or puncture of the skin. So, in addition to antibiotics, a shot of the combined tetanus, diphtheria and acellular pertussis (Tdap) vaccine is recommended for all adults ages 19 to 64, regardless of when the last tetanus or diphtheria vaccine was given. It is especially important to be vaccinated if you have an infected wound. Cat lacerations are more likely to become infected than dog lacerations.
Flea collars are more effective for the head and neck of the cat than for the tail end. Cat owners should know the risk of flea infestation and be forewarned.