infantum The puncture wound or scratch does not heal 03 the time expected. One to two weeks later, the wound is still red, inmetimes with a small amount of pus. One to six weeks after the S° ident the lymph nodes near the wound become swollen, tender, and red The child has a lowgrade fever (100°F oral, 101°F rectal). Eventually the lymph nodes may break down and discharge pus through the skin. SIGNS AND SYMPTOMS The signs of cat scratch fever are a minor cat scratch or bite that has not healed; large, tender lymph nodes; and a lowgrade fever. There may be pus in the wound. If you do not know that your child has been scratched by a cat, it may be difficult to tell cat scratch fever from any other wound infection. HOME CARE Scrub all cat scratches and bites immediately with soap and water for ten minutes. Then apply an antiseptic. If the wound becomes infected, see your doctor. PRECAUTIONS • Unsupervised play between cats and young children is dangerous to both the child and the cat. • Do not allow children to tease or torment cats or any other animals. MEDICAL TREATMENT Your doctor will rule out other illnesses by blood tests and cultures. Treatment with broadspectrum antibiotics is occasionally helpful. Cat scratch fever may require surgical incision and drainage or the complete removal of a lymph node. RELATED TOPICS: Animal bites; Glands, swollen; Puncture wounds Quick Reference Chest pain SYMPTOM • Pain anywhere in the chest HOME CARE • Give aspirin or acetaminophen. • Apply gentle heat with a heating pad. • If chest pain or soreness is caused by hard or frequent coughing, cough medicine may help. PRECAUTIONS • If chest pain is accompanied by shortness of breath, high fever, a cough producing blood flecks, or prostration (collapse), get medical help immediately. • If there is persistent pain beneath either armpit that is made worse by breathing, see your doctor. • Do not give cough medicine if the child is having difficulty in breathing. Chest pain rhest pain is common during childhood. Although chest pain in гяп be serious, it is rarely a symptom of serious disease in adults с»1 chUdren common form Qf chest pain in children is the socalled stitch the side a stabbing pain in the lower chest, more often on the left 1П, the right. This pain occurs with exercise and will stop after a S1 nute or two of rest. This type of pain may be caused by gas pains in the large intestine, contraction of the spleen, or spasm of the dia hragm (the muscular partition between the chest and abdominal cavities). Regardless of the cause, it is harmless. Pain in the area of the sternum (breastbone) is common when a child has bronchitis or a head cold combined with a cough. A frequent, hard cough often makes the diaphragm sore, causing a pain just below the ribs. Pain on one side of the chest may be caused by pleurodynia (pain from inflammation of the muscles between the ribs) or by shingles. whooping