Localized Cutaneous Infection withFrancisella TularensisResembling Ulceroglandular Tularemia in a Cat

Abstract

A chronically draining subcutaneous mass was removed from the ventral cervical region of a 6-year-old spayed female Domestic Shorthair cat. The histopathologic diagnosis was severe locally extensive pyogranulomatous and necrotizing cellulitis. Bacterial culture yielded Francisella tularensis subsp. tularensis as the causative agent. Immunohistochemical evaluation of sections for F. tularensis was negative. One year later, the cat was euthanized because of progressive lethargy found to be due to hypertrophic cardiomyopathy with pulmonary thromboembolism. No evidence of cutaneous or systemic infection by F. tularensis was found at necropsy. This case appears to be a localized form of tularemia resembling the ulceroglandular form of tularemia in humans and suggests that bacterial culture may be more sensitive than immunohistochemistry in detecting organisms in cases of localized F. tularensis infection.

Tularaemia: A challenging zoonosis

“…In domestic animals, gentamicin, enrofloxacin, doxycycline and chloramphenicol are referred to as therapeutic options for dogs [55,70]. In cats, there are reports of the use of doxycycline or enrofloxacin and amoxicilin-clavulanic acid as being beneficial in the early stages of the disease [81].…”

Francisella Tularensis Infection in Cats

“…6 Definitive diagnosis requires bacterial culture, which appeared to be more sensitive than immunohistochemistry in one case report [EBM grade IV]. 11 Culture requires specialised media but, above all, biosafety measures to protect against the risks of handling infected tissues. …”

“…9,10 The localised form manifests with chronically draining subcutaneous abscesses. 11 Some cats show oral and/or lingual ulcera-tions. 1 Laboratory abnormalities may include leukocytosis or panleukopenia, thrombocytopenia, increased serum aminotransferase and alkaline phosphatase activities, and hyperbilirubinaemia.…”

Idiopathic sterile pyogranuloma in three domestic cats

“…Generalised PI has been extensively described in the veterinary literature, particularly in cases of feline infectious peritonitis (FIP) ( Weiss & Scott , Kipar et al . ). Cutaneous, subcutaneous and, more rarely, systemic PI in cats is mainly associated with mycobacteria and fungal infections ( Malik et al . , , , Brömel & Sykes , Baral et al . ) with sporadic implication of Actinomyces, Nocardia, Rhodococcus, Streptomyces, Francisella, Bartonella and Leishmania ( Patel ; Valentine et al . ; Malik et al . ; Farias et al ., ; Santero et al . ; Sharman et al . ; Varanat et al . ; Traslavina et al . ). Idiopathic sterile pyogranulomatous dermatitis has also been described in cats ( Scott et al . ).…”