Man's painful bacterial infection linked to pet cat

The man mentioned that he had been administering medication to his sick cat before it died. (The New England Journal of Medicine 2018)

A Missouri man’s rare bacterial infection that left him with three extremely swollen lymph nodes on the right side of his face and neck was actually traced back to his pet cat.

The 68-year-old, who was not named in the case report published by the New England Journal of Medicine, had complained of a weeklong fever and the gradual painful swelling of lymph nodes.

When going through the patient’s history, he mentioned that his pet cat had died two months prior. He said “a veterinarian had diagnosed feline leukemia without laboratory testing” and he had been in charge of administering the cat’s prednisone.

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The man’s doctor ordered a series of test that came back positive for Francisella tularensis, leading to a glandular tularemia diagnosis. Tularemia is a disease transmitted from animals to humans through skin contact with infected animals; tick and deer fly bites; ingestion of contaminated water; inhalation of contaminated aerosols or agricultural dusts; or laboratory exposure. According to the case report, domestic cats can become infected through consumption of infected prey and can transmit the bacteria to humans.

According to the Centers for Disease Control and Prevention (CDC), symptoms will vary depending on the route of infection, and while it can be life-threatening, most patients will recover with antibiotics. The CDC identified six main types of tularemia, with glandular being described as similar to ulceroglandular, without the presence of ulcers.

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The CDC said glandular tularemia is generally acquired through the bite of an infected tick or deer fly, or from handling a sick animal, and typically causes swelling of lymph glands. Treatment typically lasts from 10 to 21 days, and most patients make a full recovery.

The Missouri patient was treated with doxycycline for four weeks, and his symptoms resolved.