Unconventional Infection from a Cat Scratch: A Bacterial Case Study

Strategic Insights -

A 58-year-old veterinarian experienced a severe infection in the hand and wrist after being scratched by a cat. Despite undergoing multiple courses of antibiotics, the symptoms worsened, leading to a rupture of the tendons. A broad-range bacterial PCR test identified an unspecified Mycoplasma species, which was successfully treated with oral doxycycline and surgical intervention. This case highlights the importance of broad-range bacterial PCR in detecting atypical infections, particularly in cat scratch infections with negative cultures.

Key Takeaways:

  • A 58-year-old veterinarian developed a severe infection in the hand and wrist after being scratched by a cat.
  • The symptoms worsened despite multiple courses of antibiotics, leading to a rupture of the first dorsal compartment tendons.
  • Broad-range bacterial PCR testing identified an unspecified Mycoplasma species as the causative agent.
  • The patient was treated with oral doxycycline, serial debridement, and eventual tenolysis, resulting in successful eradication of the infection and functional improvement.
  • The case highlights the clinical utility of broad-range bacterial PCR in detecting atypical infections.
  • The authors emphasize the importance of considering this modality in infections caused by cat scratches, especially with otherwise negative cultures.
  • The patient's symptoms were initially resistant to conventional antibiotic treatment.
  • The use of doxycycline was crucial in eradicating the infection.
  • Surgical intervention, including serial debridement and tenolysis, contributed to the patient's recovery.

Statistics:

  • The patient was 58 years old when the infection occurred.
  • The infection occurred in the dorsal-radial hand and wrist.
  • The patient underwent multiple courses of broad-spectrum antibiotics.
  • The symptoms worsened despite antibiotic treatment, leading to a rupture of the first dorsal compartment tendons.
  • The Mycoplasma species was identified through a broad-range bacterial PCR test.
  • The patient required oral doxycycline, serial debridement, and eventual tenolysis to eradicate the infection.
  • The infection was successfully treated, and the patient experienced functional improvement.

Sources:

  • Diagnostic Challenges and Complex Surgical Management of an Atypical Mycoplasma Infection From a Cat Scratch: A Case Report. JBJS Case Connector, 2025;15(2).
  • Kristen V. Dicks, Division of Infectious Diseases, Dept. of Medicine, Duke University School of Medicine, Durham, North Carolina.
  • Bradley J. Lauck and Tyler Pidgeon, additional authors for the research study.