What to Do If a Cat Scratches You and Draws Blood

Clean the wound immediately with soap and warm running water for at least five minutes, apply gentle pressure with a clean cloth to stop the bleeding, and then watch closely for signs of infection over the following days. That sequence handles most cat scratches, but a scratch that draws blood carries more risk than many people realize. Cat claws harbor bacteria that can cause anything from a localized skin infection to a condition called cat scratch disease, and certain groups of people face serious complications if those bacteria gain a foothold.

Immediate First Aid Steps

The single most important thing you can do after a cat scratch breaks the skin is wash it thoroughly. Hold the wound under clean running water and lather it with mild soap, working the lather gently over and around the scratch for several minutes. This removes bacteria that the claws may have deposited in the wound. Avoid scrubbing aggressively enough to damage tissue further, but don’t be shy about flushing the area well.

Once you’ve washed the scratch, pat it dry with a clean towel and apply an over-the-counter antibiotic ointment if you have one handy. Cover it with a sterile bandage or adhesive strip. If the bleeding hasn’t stopped after about ten minutes of direct pressure, or if the wound is deep enough that the edges gape open, that’s your first signal to seek medical attention rather than managing things at home.

Change the bandage daily and keep the wound clean and dry. Each time you change the dressing, check for increasing redness, swelling, warmth, or discharge. These are signs that bacteria have started multiplying under the skin, and they tend to show up within the first 24 to 72 hours.

Why Cat Scratches Are Riskier Than You’d Think

Cat claws are thin, curved, and sharp, which means they tend to create narrow puncture-like wounds rather than broad, shallow cuts. That shape matters. A puncture wound seals over at the surface quickly, trapping bacteria in the deeper tissue where oxygen levels are low and your immune system has a harder time reaching them. Research on cat-inflicted wounds has found that deeper wounds and puncture wounds are significantly more likely to become infected, and that people who tried to manage wound care at home before seeking medical treatment also had higher infection rates.

The bacteria responsible for most cat-wound infections include Pasteurella multocida, a fast-acting organism that can cause redness, swelling, and pus within hours of a scratch or bite. Pasteurella is especially common in cat-related wounds and can produce serosanguineous or purulent drainage when it takes hold.¹ On top of Pasteurella, cats can carry Bartonella henselae, the bacterium behind cat scratch disease, as well as various Staphylococcus and Streptococcus species. A single scratch can introduce any combination of these.

Older adults face a notably higher risk of wound infection from cat scratches and bites, and longer delays before professional treatment also increase that risk.² If you’re scratched on the hand or lower leg, where blood supply is somewhat limited compared to the torso, infections tend to establish themselves more easily.

Signs That a Scratch Is Getting Infected

Not every cat scratch that draws blood will become infected, but you should know the warning signs so you can act fast if they appear. Within the first day or two, watch for:

Spreading redness: A thin ring of pink around a fresh scratch is normal. Redness that expands outward from the wound, especially with red streaks running away from it, suggests the infection is moving into surrounding tissue.
Swelling and warmth: The area around the scratch becomes puffy and feels hot to the touch.
Pus or cloudy discharge: Clear fluid weeping from a fresh wound is expected. Yellow, green, or foul-smelling drainage is not.
Fever: A temperature above 100.4°F (38°C) within days of a scratch means your body is fighting something systemically.
Swollen lymph nodes: Tender, enlarged lymph nodes near the scratch site, such as in the armpit if you were scratched on the arm, can indicate cat scratch disease or another bacterial infection spreading beyond the wound.

Any of these warrants a call to your doctor. If you see red streaks tracking from the wound toward your torso, or if you develop a high fever, seek care urgently rather than waiting for a scheduled appointment.

Cat Scratch Disease

Cat scratch disease is the condition most specifically linked to cat scratches, and it catches many people off guard because it often shows up one to three weeks after the scratch itself. By that point, the original wound may have healed completely, making it easy to overlook the connection. The culprit is Bartonella henselae, a bacterium that cats pick up through flea bites and flea feces. When a cat with contaminated claws scratches you, the bacteria enter through the broken skin.³

The classic presentation starts with a small red bump or blister at the scratch site, followed by swollen, painful lymph nodes in the region that drains the scratch. If a cat scratches your forearm, for instance, you might notice a tender lump in your elbow crease or armpit. Mild fatigue, headache, and a low-grade fever often accompany the swollen nodes. In healthy adults, cat scratch disease usually resolves on its own over several weeks to a couple of months, though the swollen nodes can linger and feel alarming.

There is no single gold-standard test to diagnose cat scratch disease. Clinicians typically rely on a combination of your history of cat exposure, the physical examination findings, and blood tests for Bartonella antibodies. Even with testing, results can be mixed. In one reported case, a patient with cat scratch disease had positive blood antibody tests but a negative result on a more specific molecular test, illustrating why doctors often treat based on the full clinical picture rather than any single lab result.⁴

The bacterium doesn’t always stay localized to the lymph nodes. In rare cases it can affect the eyes, causing a condition called neuroretinitis. One case report described a patient who developed optic nerve swelling and a characteristic star-shaped pattern of deposits in the retina about two weeks after their initial symptoms appeared.⁵ Blurry vision or sudden changes in eyesight after a cat scratch should be evaluated promptly.

People Who Face Serious Complications

If you have a weakened immune system, a cat scratch that draws blood deserves urgent medical attention rather than watchful waiting. People taking immunosuppressive medications, living with HIV, undergoing chemotherapy, or managing autoimmune conditions like lupus are at considerably higher risk of severe outcomes from Bartonella and other cat-wound bacteria. In most healthy people, cat scratch disease resolves on its own. In immunocompromised individuals, the same infection can progress to sepsis or spread to internal organs.⁶

Immunosuppression also makes cat scratch disease harder to recognize. The presentation can be atypical, with unusual symptom patterns that don’t match the textbook version, which means it often goes undiagnosed in the people who are most vulnerable to it.⁷ If you fall into any of these categories, mention the scratch to your doctor even if it looks minor. Early antibiotic treatment can prevent the infection from escalating.

Young children and elderly adults also deserve extra caution. Children are scratched by cats more often than adults and may not report symptoms clearly, while older adults have a statistically higher rate of wound infection after cat injuries.²

Tetanus After a Cat Scratch

Most people associate tetanus with rusty nails, but any wound that breaks the skin, including a cat scratch, can be a route for Clostridium tetani spores. If you’re not up to date on your tetanus vaccination, a bleeding scratch is a reason to get a booster. The standard recommendation is a tetanus booster every ten years, with an additional booster if you have a dirty or deep wound and it’s been more than five years since your last shot.

Even full vaccination doesn’t make the risk zero. A case report described a 21-year-old woman who developed generalized tetanus after cat scratches and bites despite having received six childhood vaccine doses plus a booster five years earlier. She experienced headaches, muscle spasms, and mild opisthotonus, and required treatment with human antitoxin immunoglobulin before her symptoms resolved.⁸ That’s an unusual outcome, and her prior vaccination likely kept her case relatively mild. But it underscores that keeping your tetanus shots current matters, and that you should mention any animal scratch to a healthcare provider if you’re unsure of your vaccination status.

When Rabies Is a Concern

Rabies from a cat scratch is rare but not impossible. The rabies virus is primarily transmitted through saliva, and a scratch can be a route if the animal’s saliva contaminates the wound. Whether you need post-exposure prophylaxis depends largely on the circumstances of the scratch.

The biggest factor in rabies risk assessment is whether the cat is known or unknown. A retrospective analysis of three decades of data from an antirabies clinic found that post-exposure prophylaxis was administered to only about 9% of patients scratched or bitten by known-owner cats, compared to 62% of those injured by unknown cats and roughly 87% of those where the cat was suspected or confirmed rabid. In statistical modeling, the status of the cat was by far the most important factor in determining whether prophylaxis was given, far outweighing patient characteristics.⁹

If you’re scratched by your own indoor cat who’s up to date on rabies vaccination, the risk is effectively negligible. If you’re scratched by a stray or feral cat, or a cat whose vaccination status is unknown, contact your local health department or visit an emergency department. They will assess the situation and determine whether post-exposure prophylaxis is warranted. This assessment is especially critical for scratches on the face, head, or neck, where the virus would have a shorter path to the brain. A tragic case report described a 15-year-old girl who developed fatal paralytic rabies after a cat scratch on her face; she had received an anti-rabies vaccine but not anti-rabies immunoglobulin, and the virus progressed despite treatment.¹⁰ Cases like this are extremely uncommon, but they reinforce why scratches from unknown animals on high-risk body areas need rapid professional evaluation.

When to Go to a Doctor Versus Waiting It Out

Plenty of cat scratches heal on their own with nothing more than soap, water, and a bandage. But knowing where the line is between “keep an eye on it” and “get to a clinic” can save you a lot of trouble. Seek medical care if any of the following apply:

The scratch is deep or won’t stop bleeding: A scratch that gapes open or still bleeds after 10–15 minutes of pressure may need closure or professional wound care.
Signs of infection appear: Expanding redness, swelling, warmth, pus, red streaks, or fever within a few days of the scratch.
Swollen lymph nodes develop: Especially if they appear one to three weeks after the scratch and are tender or growing.
You’re immunocompromised: Any bleeding scratch warrants a call to your doctor if your immune system is weakened for any reason.
The cat was a stray or unknown: Rabies risk assessment should happen promptly.
Your tetanus vaccination is outdated: If it’s been more than five years since your last booster and the wound is dirty or deep, get one.
The scratch is on your hand or face: Hand wounds are infection-prone due to the complex anatomy of tendons and joints. Face and head wounds near the eyes carry specific risks from Bartonella, and facial scratches from unknown cats raise rabies concerns.

Your doctor may prescribe prophylactic antibiotics depending on the depth and location of the wound. Evidence suggests that puncture wounds and lower-extremity wounds in particular benefit from prophylactic antibiotics to prevent infection from developing.²

Preventing Scratches and Reducing Bacterial Risk

If you live with cats, some scratches are inevitable. But you can meaningfully reduce both the frequency of scratches and the bacterial load your cat carries on its claws.

Flea control is the single most impactful prevention measure. Bartonella henselae, the bacterium behind cat scratch disease, is transmitted among cats through flea bites and flea feces. The bacteria live in the flea’s digestive tract and are present in flea feces that accumulate in a cat’s fur and under its claws. When a cat scratches you, flea feces are effectively being ground into the wound.¹¹ Keeping your cat on a regular flea prevention regimen, whether a topical treatment, oral medication, or flea collar recommended by your vet, dramatically reduces the chance that a scratch will introduce Bartonella into your skin.

Beyond flea control, trimming your cat’s claws regularly reduces the severity of accidental scratches. A blunt-tipped claw is less likely to puncture skin deeply. Learning your cat’s body language also helps. Cats usually telegraph their discomfort with flattened ears, a twitching tail, or dilated pupils before they strike. Respecting those signals and giving the cat space prevents many defensive scratches.

If you’ve adopted a new cat or kitten, be aware that kittens are more likely to carry Bartonella than adult cats, partly because they tend to have higher flea burdens and engage in rougher play that leads to scratches. It’s worth discussing flea prevention with your vet right away and keeping interactions gentle while the kitten settles in.

The Psychological Angle

An unexpected line of research has examined the relationship between cat scratches and mental health. A cross-sectional study found that people who reported having been scratched by a cat had higher depression scores on a standardized questionnaire and were more likely to have visited psychiatrists or been previously diagnosed with depression compared to people without a history of cat scratches.¹² The association was specific to scratches rather than bites, and the study was observational, so it cannot establish cause and effect. Some researchers have speculated about a link through Toxoplasma gondii or Bartonella henselae infection, while others note that people struggling with depression may interact with cats differently or may be more likely to have multiple cats. The findings are preliminary, but they illustrate that the biological consequences of a cat scratch may extend in directions scientists are only beginning to explore.

What Your Cat’s Vaccination Status Means for You

When you’re scratched and trying to figure out your level of risk, your cat’s health profile matters almost as much as the wound itself. A strictly indoor cat that’s up to date on rabies vaccination and on regular flea prevention poses the lowest risk of transmitting anything dangerous. An outdoor cat or one with a flea problem carries a meaningfully higher load of potential pathogens. In one study from Bangladesh, about 15% of cats sampled tested positive for Bartonella, with the zoonotic species B. henselae confirmed by genetic sequencing.¹³ Prevalence varies by region and cat population, but the takeaway is that a nontrivial proportion of cats carry Bartonella at any given time, often without showing any symptoms themselves.

There’s no widely available or recommended routine test for Bartonella in cats for the purpose of preventing human disease. The more practical path is controlling the transmission chain: keep fleas off the cat, keep the cat’s claws trimmed, and wash any scratch promptly. If you’re immunocompromised and considering getting a cat, talk with both your doctor and a veterinarian. The consensus is generally that you don’t need to get rid of your cat, but you should be especially diligent about flea prevention and wound hygiene.⁶

1
PubMed. Pasteurella multocida–the major cause of hand infections following domestic animal bites
2
PubMed. Cat bite wounds: risk factors for infection
3
PubMed Central. Bartonella species infection in cats: ABCD guidelines on prevention and management
4
PubMed Central. Diagnosis and interpretation of testing for cat scratch disease
5
PubMed Central. Neuroretinitis as a Complication of Cat Scratch Disease
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PubMed Central. Cat scratch disease sepsis in an immunocompromised patient
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PubMed. Cat scratch disease in an immunosuppressed patient with systemic lupus erythematosus
8
PubMed. Tetanus after cat scratch and bites in a previously immunized patient
9
PubMed Central. Cat-Related Injuries and Rabies Exposure: A Three-Decade Retrospective Analysis from the Zagreb Antirabies Clinic (1995-2025)
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PubMed Central. Paralytic rabies following cat scratch and intra-dermal anti-rabies vaccination
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PubMed Central. Cat scratch disease: What to do with the cat?
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PubMed Central. Cat scratches, not bites, are associated with unipolar depression – cross-sectional study
13
PubMed Central. Epidemiology of feline bartonellosis and molecular characteristics of Bartonella henselae in Bangladesh