Can cat bites cause massive ulcers in the legs of chemotherapy (chemo) patients?

From the Guidelines

Yes, cat bites can potentially cause serious infections that may lead to ulcers in the legs of chemotherapy patients. Chemotherapy often suppresses the immune system, making patients more vulnerable to infections that might be minor in healthy individuals. When a cat bites, it can introduce bacteria like Pasteurella multocida, Streptococcus, Staphylococcus, and other organisms deep into tissues. For immunocompromised patients, these infections can rapidly progress to cellulitis, abscesses, and even necrotizing fasciitis, which can present as massive ulcers.

Key Considerations

• The risk of infection from cat bites is higher in immunocompromised patients, such as those undergoing chemotherapy 1.
• Prompt treatment is crucial to prevent serious complications, including the development of massive ulcers 1.
• Treatment typically includes thorough wound cleaning and antibiotics, such as amoxicillin-clavulanate (875/125 mg twice daily for 7-14 days) or intravenous antibiotics like ampicillin-sulbactam in severe cases 1.

Management

• Chemotherapy patients should seek immediate medical attention if they experience a cat bite, even if the bite seems minor.
• Patients should be especially cautious during periods of neutropenia (low white blood cell count) and report any animal bites to their oncologist immediately.
• Elevation of the affected area and treatment of predisposing factors, such as edema or underlying cutaneous disorders, are also recommended 1.

Prevention

• Measures to reduce recurrences of cellulitis include treating interdigital maceration, keeping the skin well hydrated with emollients, and reducing any underlying edema 1.
• Prophylactic antibiotics may be considered for patients with frequent infections, although published results demonstrating efficacy have been mixed 1.

From the Research

Cat Bites and Infections in Chemo Patients

• Cat bites can cause infections in anyone, but people with weakened immune systems, such as those undergoing chemotherapy, are more susceptible to severe infections 2, 3.
• Pasteurella multocida is the most common bacteria isolated from cat bite wounds, and it can cause serious infections, including sepsis, in immunocompromised patients 4, 2, 5, 3, 6.
• Infections from cat bites can progress rapidly, and delayed medical attention can lead to severe consequences, including death 3.

Risk of Massive Ulcers in the Legs

• While there is no direct evidence of cat bites causing massive ulcers in the legs of chemo patients, infections from cat bites can lead to abscesses, cellulitis, and other complications that may affect the legs 4, 6.
• Immunocompromised patients, such as those undergoing chemotherapy, are at a higher risk of developing severe infections and complications from cat bites 2, 3.

Prevention and Treatment

• Prevention of cat bites and scratches is crucial, especially for immunocompromised patients 2, 3.
• Prompt medical attention and appropriate antibiotic treatment can help prevent severe infections and complications from cat bites 4, 5, 6.
• Amoxicillin-clavulanate is a recommended antibiotic treatment for cat bite wounds, as it covers Pasteurella multocida and other common pathogens 5, 6.