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Cat bite

Cat bites are bites inflicted upon humans, other cats, and other animals by the domestic cat (Latin: Felis catus).[1][2] Data from the United States show that cat bites represent between 5–15% of all animal bites inflicted to humans,[3][4] but it has been argued that this figure could be the consequence of under-reporting as bites made by Felis catus are considered by some to be unimportant.[5][6] Though uncommon, cat bites can sometimes cause rabies lead to complications and, very rarely, death.[7][8]

Cat bite
A cat wounded from the bite of another cat
SpecialtyEmergency medicine, plastic surgery, pediatrics, veterinary medicine

Signs and symptoms edit

Cat bites are usually considered minor injuries but can result in serious infection and cause rabies if inflicted by a rabid cat.[9] Common symptoms include pain and swelling around the affected area.[3] Sometimes, direct tissue damage from the cat bite can impair mobility or cause tenosynovitis or arthritis.[10] In these cases, surgical consultation is needed to assess severity.[3][4] Some unusual complications, like deep-vein thrombosis,[5] subcutaneous emphysema[11] and fetal tachycardia[11] have been described. Some of the infections acquired from a cat bite can be acquired otherwise, like plague.[12]

Infections edit

 
Ancylostoma braziliense mouthparts

The resident flora in the mouth of the domestic cat includes Pasteurella, Staph, Bartonella, Globicatella[13] and Streptococcus species.[9] Bites from cats develop infections more frequently than bites from dogs.[6] 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.[14][8] The bite from a cat can infect a person with:

In people, pasteurellosis causes painful wound 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. Animals 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.[20]

Diagnosis edit

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 is noted. The person may have drainage from the site of the bite. They may also be febrile, and 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 prior to exploration. Neurovascular status is assessed. Immune status may determine treatment as does the presence of transplanted tissue or organs, rheumatic disease, diabetes, HIV/AIDS and sickle cell disease. Swollen lymph nodes and red streaks radiating upward may be evident.[21][15][9]

The diagnosis of a cat with 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 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.[20]

Prevention edit

Cat bites can often be prevented by:

  • avoiding cats
  • instructing children not to tease cats or other pets[22]
  • 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 in an effort to defend itself.

In the case of dogs, the potential for attack is well known. Unfortunately not in cats, although there are countless documented[23][24] cases.

Treatment edit

The first step in treatment includes washing and then irrigating the bite wound with water and isopropyl alcohol.[25][26][9] Often, a tetanus shot is prescribed.[8] 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 veterinarian. If the wound has a low risk of being infected, it is sometimes only sutured.[25] 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.[22] 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.[20]

Epidemiology edit

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.[21] 40 million households in the United States have domestic cats.[27] 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.[18] 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.[20] Because of their smaller build, children are more likely to be bitten on their head, neck and face. Adults are more likely to bitten on the hands and arms.[9] Those who are immunocompromised are more susceptible to infection from a cat bite.[8]

Data show that cat bites are more common found in women than in men,[3] and in older adults, particularly those over 75 years old.[3] Cat bites are more frequent in the mornings,[3] during spring and summer.[6] The most commonly affected human body part are the arms.[3] Attackers are usually stray females.[6]

See also edit

References edit

  1. ^ Wozencraft, W. C. (2005). "Species Felis catus". In Wilson, D. E.; Reeder, D. M. (eds.). Mammal Species of the World: A Taxonomic and Geographic Reference (3rd ed.). Johns Hopkins University Press. pp. 534–535. ISBN 978-0-8018-8221-0. OCLC 62265494.
  2. ^ "ITIS Standard Report Page: Felis catus". ITIS Online Database. Reston, Virginia: Integrated Taxonomic Information System. 2011. Retrieved 14 December 2011.
  3. ^ a b c d e f g Aziz, Hassan; Rhee, Peter; Pandit, Viraj; Tang, Andrew; Gries, Lynn; Joseph, Bellal (2015-03-01). "The current concepts in management of animal (dog, cat, snake, scorpion) and human bite wounds". Journal of Trauma and Acute Care Surgery. 78 (3): 641–648. doi:10.1097/TA.0000000000000531. ISSN 2163-0755. PMID 25710440. S2CID 27833551.
  4. ^ a b Olcott, Jessica L.; Bula-Rudas, Fernando J. (2018-10-01). "Human and Animal Bites". Pediatrics in Review. 39 (10): 490–500. doi:10.1542/pir.2017-0212. ISSN 0191-9601. PMID 30275032. S2CID 52898850.
  5. ^ a b G­arrama-Conzuelo, F; Gutierrez-Castillo, A (2019-06-17). "Cathrombosis: Deep Vein Thrombosis After a Cat Bite - A Case Report". Cureus. 11 (6): e4924. doi:10.7759/cureus.4924. PMC 6692098. PMID 31423400.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  6. ^ a b c d Philipsen, T. E. J.; Molderez, C.; Gys, T. (2006-01-01). "Cat And Dog Bites. What To Do?". Acta Chirurgica Belgica. 106 (6): 692–695. doi:10.1080/00015458.2006.11679983. ISSN 0001-5458. PMID 17290697. S2CID 38532972.
  7. ^ Gurry, Greta A.; Campion, Veronique; Premawardena, Chamath; Woolley, Ian; Shortt, Jake; Bowden, Donald K.; Kaplan, Zane; Dendle, Claire (2017). "High rates of potentially infectious exposures between immunocompromised patients and their companion animals: an unmet need for education". Internal Medicine Journal. 47 (3): 333–335. doi:10.1111/imj.13361. hdl:11343/292579. ISSN 1444-0903. PMID 28260250. S2CID 34956653.
  8. ^ a b c d e "First Aid: Animal Bites". The Nemours Foundation. 2017. Retrieved 2017-06-18.
  9. ^ a b c d e Maniscalco, K; Edens, MA (April 20, 2017). "Animal Bites". National Center for Biotechnology Information, U.S. National Library of Medicine. PMID 28613602. Retrieved June 17, 2017.
  10. ^ Jorup, Christina; Wretlind, Bengt; Settergren, Bo; Sandstedt, Karin; Ekblom, Anna Gerber; Cars, Björn; Farra, Anna; Westling, Katarina (2006-12-01). "Cat bite wound infections: A prospective clinical and microbiological study at three emergency wards in Stockholm, Sweden". Journal of Infection. 53 (6): 403–407. doi:10.1016/j.jinf.2006.01.001. ISSN 0163-4453. PMID 16483663.
  11. ^ a b Wagner, Brian K.; Martone, Jeffrey D.; Conte, Harry; Hill, Melissa; Kusan, Karuna (September 2006). "Complications of a Cat Bite". Journal of the American Podiatric Medical Association. 96 (5): 455–457. doi:10.7547/0960455. ISSN 8750-7315. PMID 16988179.
  12. ^ Gage, K. L.; Dennis, D. T.; Orloski, K. A.; Ettestad, P.; Brown, T. L.; Reynolds, P. J.; Pape, W. J.; Fritz, C. L.; Carter, L. G.; Stein, J. D. (2000). "Cases of Cat-Associated Human Plague in the Western US, 1977-1998". Clinical Infectious Diseases. 30 (6): 893–900. doi:10.1086/313804. ISSN 1058-4838. PMID 10852811.
  13. ^ UK man bitten by cat contracts previously unknown and ‘extensive’ bacterial infection
  14. ^ . Handcare.org. American Society for Surgery of the Hand. 2017. Archived from the original on 28 July 2017. Retrieved 18 June 2017.
  15. ^ a b "Cat scratch disease". U.S. National Library of Medicine. September 10, 2015. Retrieved June 17, 2017.
  16. ^ Rijks, J. M.; Cito, F.; Cunningham, A. A.; Rantsios, A.T.; Giovannini, A. (2016). "Disease Risk Assessments Involving Companion Animals: an Overview for 15 Selected Pathogens Taking a European Perspective". Journal of Comparative Pathology. 155 (1): S75–S97. doi:10.1016/j.jcpa.2015.08.003. ISSN 0021-9975. PMID 26422413.
  17. ^ Joanna Zajkowska, Monika Król, Daniel Falkowski, Norina Syed, Anna Kamieńska. "Capnocytophaga canimorsus – An Underestimated Danger After Dog or Cat Bite – Review of the Literature", Przegl Epidemiol. 2016;70(2):289-295. n.d.
  18. ^ a b Lloret, Albert; Egberink, Herman; Addie, Diane; Belák, Sándor; Boucraut-Baralon, Corine; Frymus, Tadeusz; Gruffydd-Jones, Tim; Hartmann, Katrin; Hosie, Margaret J; Lutz, Hans; Marsilio, Fulvio; Möstl, Karin; Pennisi, Maria Grazia; Radford, Alan D; Thiry, Etienne; Truyen, Uwe; Horzinek, Marian C (2013). "Pasteurella Multocida Infection in Cats". Journal of Feline Medicine and Surgery. 15 (7): 570–572. doi:10.1177/1098612X13489215. hdl:2268/187998. ISSN 1098-612X. PMID 23813817. S2CID 10682140.
  19. ^ Chomel, Bruno (2014). "Emerging and Re-Emerging Zoonoses of Dogs and Cats". Animals. 4 (3): 434–445. doi:10.3390/ani4030434. ISSN 2076-2615. PMC 4494318. PMID 26480316.
  20. ^ a b c d https://www.cdc.gov/healthypets/pets/cats.html   This article incorporates public domain material from websites or documents of the Centers for Disease Control and Prevention.
  21. ^ a b "Prevent Bite Wounds". American Academy of Pediatrics. 2017. Retrieved June 17, 2017.
  22. ^ a b "First Aid: Animal Bites (for Parents) - KidsHealth".
  23. ^ "German cat attack: Animal Bites (for Parents) - KidsHealth". 15 August 2019.
  24. ^ "Woman dies after bite: Animal Bites (for Parents) - KidsHealth". TVNZ.
  25. ^ a b "Animal bites Fact sheet N°373". World Health Organization. February 2013. Retrieved June 17, 2017.
  26. ^ https://www.cdc.gov/healthypets/pets/cats.html#what-to-do   This article incorporates public domain material from websites or documents of the Centers for Disease Control and Prevention.
  27. ^ https://www.cdc.gov/rabies/pets/index.html   This article incorporates public domain material from websites or documents of the Centers for Disease Control and Prevention.

External links edit

  • Self care for animal bites

bite, bites, inflicted, upon, humans, other, cats, other, animals, domestic, latin, felis, catus, data, from, united, states, show, that, bites, represent, between, animal, bites, inflicted, humans, been, argued, that, this, figure, could, consequence, under, . Cat bites are bites inflicted upon humans other cats and other animals by the domestic cat Latin Felis catus 1 2 Data from the United States show that cat bites represent between 5 15 of all animal bites inflicted to humans 3 4 but it has been argued that this figure could be the consequence of under reporting as bites made by Felis catus are considered by some to be unimportant 5 6 Though uncommon cat bites can sometimes cause rabies lead to complications and very rarely death 7 8 Cat biteA cat wounded from the bite of another catSpecialtyEmergency medicine plastic surgery pediatrics veterinary medicine Contents 1 Signs and symptoms 2 Infections 3 Diagnosis 4 Prevention 5 Treatment 6 Epidemiology 7 See also 8 References 9 External linksSigns and symptoms editCat bites are usually considered minor injuries but can result in serious infection and cause rabies if inflicted by a rabid cat 9 Common symptoms include pain and swelling around the affected area 3 Sometimes direct tissue damage from the cat bite can impair mobility or cause tenosynovitis or arthritis 10 In these cases surgical consultation is needed to assess severity 3 4 Some unusual complications like deep vein thrombosis 5 subcutaneous emphysema 11 and fetal tachycardia 11 have been described Some of the infections acquired from a cat bite can be acquired otherwise like plague 12 Infections edit nbsp Ancylostoma braziliense mouthpartsFurther information Feline zoonosis The resident flora in the mouth of the domestic cat includes Pasteurella Staph Bartonella Globicatella 13 and Streptococcus species 9 Bites from cats develop infections more frequently than bites from dogs 6 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 14 8 The bite from a cat can infect a person with Cat scratch disease caused by the bacterium Bartonella henselae 8 15 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 kittens younger than one year of age are more likely to have it 16 Most cats with this infection show no signs of illness Hookworm Ancylostoma tubaeforme Ancylostoma braziliense and Uncinaria stenocephala Capnocytophaga canimorsus 17 Pasteurellosis caused by the bacterial genus Pasteurella 18 19 Pasteurellosis is a bacterial disease associated with animal bites and scratches Pasteurella spp is a normal bacterium that also lives in the mouths of healthy cats The 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 wound 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 Animals 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 20 Diagnosis editThe 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 is noted The person may have drainage from the site of the bite They may also be febrile and 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 prior to exploration Neurovascular status is assessed Immune status may determine treatment as does the presence of transplanted tissue or organs rheumatic disease diabetes HIV AIDS and sickle cell disease Swollen lymph nodes and red streaks radiating upward may be evident 21 15 9 The diagnosis of a cat with 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 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 20 Prevention editCat bites can often be prevented by avoiding cats instructing children not to tease cats or other pets 22 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 in an effort to defend itself In the case of dogs the potential for attack is well known Unfortunately not in cats although there are countless documented 23 24 cases Treatment editThe first step in treatment includes washing and then irrigating the bite wound with water and isopropyl alcohol 25 26 9 Often a tetanus shot is prescribed 8 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 veterinarian If the wound has a low risk of being infected it is sometimes only sutured 25 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 22 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 20 Epidemiology editThe examples and perspective in this article may not represent a worldwide view of the subject You may improve this article discuss the issue on the talk page or create a new article as appropriate December 2017 Learn how and when to remove this template message 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 21 40 million households in the United States have domestic cats 27 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 18 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 20 Because of their smaller build children are more likely to be bitten on their head neck and face Adults are more likely to bitten on the hands and arms 9 Those who are immunocompromised are more susceptible to infection from a cat bite 8 Data show that cat bites are more common found in women than in men 3 and in older adults particularly those over 75 years old 3 Cat bites are more frequent in the mornings 3 during spring and summer 6 The most commonly affected human body part are the arms 3 Attackers are usually stray females 6 See also editDog biteReferences edit Wozencraft W C 2005 Species Felis catus In Wilson D E Reeder D M eds Mammal Species of the World A Taxonomic and Geographic Reference 3rd ed Johns Hopkins University Press pp 534 535 ISBN 978 0 8018 8221 0 OCLC 62265494 ITIS Standard Report Page Felis catus ITIS Online Database Reston Virginia Integrated Taxonomic Information System 2011 Retrieved 14 December 2011 a b c d e f g Aziz Hassan Rhee Peter Pandit Viraj Tang Andrew Gries Lynn Joseph Bellal 2015 03 01 The current concepts in management of animal dog cat snake scorpion and human bite wounds Journal of Trauma and Acute Care Surgery 78 3 641 648 doi 10 1097 TA 0000000000000531 ISSN 2163 0755 PMID 25710440 S2CID 27833551 a b Olcott Jessica L Bula Rudas Fernando J 2018 10 01 Human and Animal Bites Pediatrics in Review 39 10 490 500 doi 10 1542 pir 2017 0212 ISSN 0191 9601 PMID 30275032 S2CID 52898850 a b G arrama Conzuelo F Gutierrez Castillo A 2019 06 17 Cathrombosis Deep Vein Thrombosis After a Cat Bite A Case Report Cureus 11 6 e4924 doi 10 7759 cureus 4924 PMC 6692098 PMID 31423400 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint multiple names authors list link a b c d Philipsen T E J Molderez C Gys T 2006 01 01 Cat And Dog Bites What To Do Acta Chirurgica Belgica 106 6 692 695 doi 10 1080 00015458 2006 11679983 ISSN 0001 5458 PMID 17290697 S2CID 38532972 Gurry Greta A Campion Veronique Premawardena Chamath Woolley Ian Shortt Jake Bowden Donald K Kaplan Zane Dendle Claire 2017 High rates of potentially infectious exposures between immunocompromised patients and their companion animals an unmet need for education Internal Medicine Journal 47 3 333 335 doi 10 1111 imj 13361 hdl 11343 292579 ISSN 1444 0903 PMID 28260250 S2CID 34956653 a b c d e First Aid Animal Bites The Nemours Foundation 2017 Retrieved 2017 06 18 a b c d e Maniscalco K Edens MA April 20 2017 Animal Bites National Center for Biotechnology Information U S National Library of Medicine PMID 28613602 Retrieved June 17 2017 Jorup Christina Wretlind Bengt Settergren Bo Sandstedt Karin Ekblom Anna Gerber Cars Bjorn Farra Anna Westling Katarina 2006 12 01 Cat bite wound infections A prospective clinical and microbiological study at three emergency wards in Stockholm Sweden Journal of Infection 53 6 403 407 doi 10 1016 j jinf 2006 01 001 ISSN 0163 4453 PMID 16483663 a b Wagner Brian K Martone Jeffrey D Conte Harry Hill Melissa Kusan Karuna September 2006 Complications of a Cat Bite Journal of the American Podiatric Medical Association 96 5 455 457 doi 10 7547 0960455 ISSN 8750 7315 PMID 16988179 Gage K L Dennis D T Orloski K A Ettestad P Brown T L Reynolds P J Pape W J Fritz C L Carter L G Stein J D 2000 Cases of Cat Associated Human Plague in the Western US 1977 1998 Clinical Infectious Diseases 30 6 893 900 doi 10 1086 313804 ISSN 1058 4838 PMID 10852811 UK man bitten by cat contracts previously unknown and extensive bacterial infection Animal Bites Handcare org American Society for Surgery of the Hand 2017 Archived from the original on 28 July 2017 Retrieved 18 June 2017 a b Cat scratch disease U S National Library of Medicine September 10 2015 Retrieved June 17 2017 Rijks J M Cito F Cunningham A A Rantsios A T Giovannini A 2016 Disease Risk Assessments Involving Companion Animals an Overview for 15 Selected Pathogens Taking a European Perspective Journal of Comparative Pathology 155 1 S75 S97 doi 10 1016 j jcpa 2015 08 003 ISSN 0021 9975 PMID 26422413 Joanna Zajkowska Monika Krol Daniel Falkowski Norina Syed Anna Kamienska Capnocytophaga canimorsus An Underestimated Danger After Dog or Cat Bite Review of the Literature Przegl Epidemiol 2016 70 2 289 295 n d a b Lloret Albert Egberink Herman Addie Diane Belak Sandor Boucraut Baralon Corine Frymus Tadeusz Gruffydd Jones Tim Hartmann Katrin Hosie Margaret J Lutz Hans Marsilio Fulvio Mostl Karin Pennisi Maria Grazia Radford Alan D Thiry Etienne Truyen Uwe Horzinek Marian C 2013 Pasteurella Multocida Infection in Cats Journal of Feline Medicine and Surgery 15 7 570 572 doi 10 1177 1098612X13489215 hdl 2268 187998 ISSN 1098 612X PMID 23813817 S2CID 10682140 Chomel Bruno 2014 Emerging and Re Emerging Zoonoses of Dogs and Cats Animals 4 3 434 445 doi 10 3390 ani4030434 ISSN 2076 2615 PMC 4494318 PMID 26480316 a b c d https www cdc gov healthypets pets cats html nbsp This article incorporates public domain material from websites or documents of the Centers for Disease Control and Prevention a b Prevent Bite Wounds American Academy of Pediatrics 2017 Retrieved June 17 2017 a b First Aid Animal Bites for Parents KidsHealth German cat attack Animal Bites for Parents KidsHealth 15 August 2019 Woman dies after bite Animal Bites for Parents KidsHealth TVNZ a b Animal bites Fact sheet N 373 World Health Organization February 2013 Retrieved June 17 2017 https www cdc gov healthypets pets cats html what to do nbsp This article incorporates public domain material from websites or documents of the Centers for Disease Control and Prevention https www cdc gov rabies pets index html nbsp This article incorporates public domain material from websites or documents of the Centers for Disease Control and Prevention External links editSelf care for animal bites Retrieved from https en wikipedia org w index php title Cat bite amp 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