Animal-Borne Illness - Dr. Cox

​Cat Scratch Disease:

• Clinical diagnosis!
• Think Lymphadenopathy… then fever and constitutional symptoms
• Usually self-limited, can treat with azithromycin x5days
• http://pedemmorsels.com/cat-scratch-disease/

 
Toxoplasmosis

• Immunocompetent: Vast majority asymptomatic
• Immunocompromised
  • Toxoplasmic Encephalitis
    • Most common CNS infection  in AIDS pt  not on ppx

Presumptive Dx:

• CD4+ <100
• Not on appropriate PPx
• Compatible clinical syndrome
• T. gondii IgG Ab positive
• Ring enhancing lesions on imaging
  • MRI preferred (more sensitive)
• Tx: Pyrimethamine, Sulfadiazine, Leucovorin x 6 wks

 
Bites:

• Check vaccination status of patient and animal
• HIGH PRESSURE, COPIOUS irrigation
• Dogs:
  • Close bites if <12 hours old, <24 hours on face
• Cats: DO NOT CLOSE (unless terrible cosmetic injury)
• PPx:           
  • ALL CAT BITES
  • Dog bites if:
    • >8hours old
    • Face, genitals
    • Tendon, joints, bone
    • Immunocompromised, poor wound healing
  • Tx: Augmentin x3-5days
• Bad Pathogens:
  • Pasteurella = CAN’T use 1st gen cephalosporins or clindamycin
    • Tx: Augmentin, Unasyn, Zosyn
  • Capnocytophaga = Bad hombre           
    • Immunocompromised
    • Asplenic
    • Hepatic disease
    • Tx: IV Zosyn, cephalosporins, carbapenems

 
Toxocariasis:

• Think Children, sandboxes, exposure to feces
• Spectrum of disease: asymptomatic -> organ failure
• 2 flavors:
  • Visceral Larva Migrans
  • Ocular Larva Migrans: vision loss
  • (3rd flavor is Cutaneous Larva Migrans. Caused by Ancylostoma)
• Tx: VLM: Albendazole x5 days, +/- prednisone

       OLM: Prednisone (slow taper), Albendazole x2-4weeks
 

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