Abstract:
UNASSIGNED: 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 Mycobacterium goodii. 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.
UNASSIGNED: This is the second reported feline cutaneous M goodii 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.
摘要:
未经评估:一名9岁的家养短腿母猫被送往转诊医院,以治疗复发性不愈合的溃疡和腹侧腹部皮下肿块。先前的治疗包括抗生素(头孢霉素,然后是克林霉素),伤口清洁和手术切除,但溃疡和肿块在手术切除后1个月复发。在这一点上,这只猫开始服用多西环素和普拉多氟沙星,并转诊进行进一步检查。转诊时获得的皮肤活检标本的培养物显示出具有两种明显不同表型的细菌菌落群。基质辅助激光解吸/电离飞行时间质谱和16SrRNA基因测序将两个菌落都鉴定为高二分枝杆菌。诊断为快速生长的分枝杆菌的皮肤感染,并开始口服普拉氧氟沙星和多西环素治疗。溃疡在4个月内解决,皮下肿块逐渐减小,直到不再明显,甚至在抗生素停止后4个月。
未经证实:这是北美第二次报道的猫科动物皮肤Mgoodii感染。在组织病理学上未观察到该生物,但从通过皮肤穿刺活检获得的组织中成功培养了该生物。怀疑有影响易感性结果的表型转换现象,可能解释了表型不同但遗传相同的菌株的存在。这个案例强调了提交无菌获得的组织的重要性,用于培养和物种鉴定的流体或细针抽吸物,以及组织病理学,当感染高级细菌时,如快速生长的分枝杆菌,被怀疑。