Cat Scratch Injury: When to Get Tetanus Shots and Monitor Healing

Wild cat scratch?

Hello, doctor.
I was scratched by a stray cat, and I have three scratch marks on my finger that are not very large (about 2 to 3 centimeters long).
The depth is shallow, but the skin is broken, and there is slight bleeding.
I first washed my hands with soap and squeezed out a little blood before seeking medical attention.
Do I need a tetanus shot? The clinic doctor asked if I wanted the injection, and it seemed optional, but I decided to get it just in case since it has been over ten years since my last tetanus shot.
After disinfecting the wound, applying medication, and bandaging it, I was also prescribed a two-day course of antibiotics.
The doctor said I could remove the bandage at the same time the next day, but if I'm not confident, I can change the dressing again.
How long should I observe the wound to be safe? Additionally, the injection site is a bit painful; is this a normal reaction? Please clarify, thank you!

Jimmy, 20~29 year old female. Ask Date: 2015/06/03

Dr. Ke Fangxu reply Surgery

1.
Traditional beliefs suggest that only deep wounds require a tetanus shot; however, recent literature indicates that superficial wounds also carry a risk of tetanus infection, which contributes to the uncertainty about whether to administer the vaccine.
2.
If the wound is very shallow, observation for three days is sufficient; if the dermis is involved, it is advisable to observe for one week.
3.
Swelling and pain at the site of the tetanus injection are normal phenomena, so there is no need for excessive concern.

Reply Date: 2015/06/03

More Info

When it comes to cat scratch injuries, especially those caused by wild or stray cats, there are several important considerations regarding tetanus shots, wound care, and monitoring for infection.
First, regarding your question about whether you need a tetanus shot after being scratched by a cat, the general recommendation is based on the nature of the wound and your vaccination history. Tetanus is caused by a bacterium that can enter the body through wounds, and while it is more commonly associated with deep puncture wounds, even superficial wounds can pose a risk if they are contaminated. The Centers for Disease Control and Prevention (CDC) recommends that adults receive a tetanus booster every 10 years. If your last tetanus shot was more than 10 years ago, it is advisable to get a booster, especially after an injury. Since you mentioned that your last shot was over 10 years ago, getting the booster was a prudent decision.

In terms of wound care, you did the right thing by washing the wound with soap and water immediately after the injury. This is crucial in reducing the risk of infection. After cleaning, applying an antiseptic and covering the wound with a bandage helps protect it from further contamination. Your physician's advice to take antibiotics is also standard practice, especially if there is a risk of infection from a cat scratch, as cats can carry bacteria such as Bartonella henselae, which causes cat scratch fever, and other pathogens.

As for monitoring the healing process, it is generally recommended to observe the wound for signs of infection for at least 3 to 7 days. Look for increased redness, swelling, warmth, or pus, which could indicate an infection. If you notice any of these symptoms, or if the pain worsens, it is important to seek medical attention promptly.
Regarding the pain at the injection site after receiving the tetanus shot, it is common to experience some soreness, swelling, or redness at the injection site. This is a normal reaction as your body responds to the vaccine and builds immunity. However, if the pain becomes severe or if you develop a fever or other unusual symptoms, you should consult a healthcare provider.

In summary, you took appropriate steps after your cat scratch injury by cleaning the wound and seeking medical advice. Getting the tetanus booster was a wise choice given your vaccination history. Continue to monitor the wound for any signs of infection over the next week, and don't hesitate to reach out to your healthcare provider if you have any concerns. It's always better to err on the side of caution when it comes to potential infections from animal bites or scratches.

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