Wu Chi-Yen, Diaz Sandra, Ellis Angela, Jones Rebekah, Pucheu-Haston Cherie
Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA.
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.
JFMS Open Rep. 2022 Apr 19;8(1):20551169221090442. doi: 10.1177/20551169221090442. eCollection 2022 Jan-Jun.
A 9-year-old spayed female domestic shorthair cat was presented to a referral hospital for management of recurring non-healing ulcerations and a subcutaneous mass on the ventral abdomen. Prior treatment included antibiotics (cefovecin followed by clindamycin), wound cleaning and surgical debulking, but the ulcerations and mass recurred 1 month after surgical removal. At this point, the cat was started on doxycycline and pradofloxacin and referred for further work-up. The culture of skin biopsy specimens obtained at the time of referral revealed a population of bacterial colonies with two distinctly different phenotypes. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16S rRNA gene sequencing identified both colonies as . A diagnosis of a cutaneous infection of rapidly growing mycobacteria was made, and treatment with oral pradofloxacin and doxycycline was initiated. The ulcerations resolved within 4 months, and the subcutaneous mass gradually decreased in size until it was no longer palpable, even 4 months after the cessation of antibiotics.
This is the second reported feline cutaneous infection in North America. The organism was not visualized on histopathology but was successfully cultured from tissue obtained by skin punch biopsy. A phenotypic switching phenomenon affecting the susceptibility results was suspected, possibly explaining the presence of phenotypically different but genetically identical strains. This case highlights the importance of submitting aseptically obtained tissue, fluid or fine-needle aspirates for culture and species identification, as well as histopathology, when infection with higher bacteria, such as rapidly growing mycobacteria, is suspected.
一只9岁已绝育的雌性家猫被转诊至一家专科医院，以处理其腹部反复出现的不愈合溃疡和皮下肿块。先前的治疗包括使用抗生素（先使用头孢维星，后使用克林霉素）、伤口清理和手术减瘤，但手术切除后1个月，溃疡和肿块再次出现。此时，该猫开始使用强力霉素和普拉德氟沙星，并被转诊进行进一步检查。转诊时获取的皮肤活检标本培养显示有一群具有两种明显不同表型的细菌菌落。基质辅助激光解吸/电离飞行时间质谱分析和16S rRNA基因测序确定这两种菌落均为……。诊断为快速生长分枝杆菌皮肤感染，并开始使用口服普拉德氟沙星和强力霉素进行治疗。溃疡在4个月内愈合，皮下肿块大小逐渐减小，直至在停止使用抗生素4个月后再也触诊不到。
这是北美第二例报告的猫皮肤感染病例。该病原体在组织病理学检查中未被发现，但通过皮肤穿刺活检获取的组织成功培养出该病原体。怀疑存在影响药敏结果的表型转换现象，这可能解释了表型不同但基因相同的菌株的存在。该病例强调了在怀疑感染快速生长分枝杆菌等高等级细菌时，提交无菌获取的组织、液体或细针穿刺抽吸物进行培养和菌种鉴定以及组织病理学检查的重要性。
