In the latest Case Record of the Massachusetts General Hospital, a 29-year-old woman was admitted to the hospital because of fever after a cat bite. The patient had been well until 5 days before admission, when, while working as a veterinarian’s assistant at an animal hospital, she was bitten on the right thenar eminence by a domesticated cat, sustaining a single puncture wound.
The normal flora of the oral cavity of the domestic cat includes Pasteurella multocida and other bacteria, as well as pathogens that may be acquired from the environment or from mammals and birds that the cat may have encountered.
• What is the routine treatment after a cat bite in veterinary practices?
The routine protocol after a cat bite in veterinary practices consists of a single dose of amoxicillin.
• What is the most frequent cause of infection from a cat bite?
P. multocida resides in the anterior oral cavity of the cat and is the most frequent cause of infection, including painful cellulitis, from cat bites.
Morning Report Questions
Q: What is a typical presentation of tularemia?
A: The characteristics of infection with F. tularensis include a subacute illness, with high fever, headache, painful regional lymphadenopathy, generalized arthralgias, and mild liver-function abnormalities.
Q: How should tularemia be treated?
A: Treatment of F. tularensis has traditionally involved either streptomycin or, more recently, gentamicin. Oral therapy with doxycycline and ciprofloxacin, extending for a minimum of 3 weeks to avoid treatment failure, has been successful.
Table 4. Oral and Acquired Flora That May Be Associated with Cats.