Investigation and Outcomes
On January 19, 2024, a 2-year-old cat began receiving veterinary care in Central Oregon for a neck abscess and vomiting. The cat was initially treated with an oral antibiotic. On January 24, the abscess was excised and drained by a veterinarian.
On January 25, the cat’s owner, a man aged 73 years, cut his right index finger with a kitchen knife and sought treatment at an urgent care facility in Central Oregon. The wound was irrigated and sutured, and the man returned home. That same day, the man had close contact with his cat, which was still under veterinary care. On January 26, the man noticed a new, tender, raised ulcer on his right wrist, and 4 days later he sought care at an emergency department. His signs and symptoms included cellulitis and lymphadenitis extending up to his right axilla, originating from the ulcerated wrist lesion. He was admitted to the hospital and initially treated with empiric intravenous ceftriaxone and metronidazole for bacterial lymphangitis. Y. pestis was detected by blood culture evaluated at the hospital microbiology laboratory and was confirmed by polymerase chain reaction (PCR) and bacteriophage-lysis testing at the Washington State Public Health Laboratory on February 6. At the time the isolate was identified, Oregon State Public Health Laboratory was undergoing renovations and Washington State Public Health Laboratory agreed to support and perform pathogen testing by PCR as needed.
Based on culture results, antibiotic therapy was changed to intravenous gentamicin and intravenous levofloxacin, which resulted in improvement in the patient’s cellulitis, lymphangitis, and lymphadenitis. On February 7, he was discharged and prescribed a 9-day course of oral levofloxacin. At his follow-up appointment on February 15, he appeared to have made a full recovery, with only mild residual fatigue.
The owner was not able to give the cat its antibiotics after surgery, and the cat died on January 31. The Washington State Public Health Laboratory reported the man’s positive Y. pestis test results to the Oregon State Public Health Laboratory and Oregon’s public health veterinarian, who contacted CDC to request confirmatory testing of the cat. CDC’s Diagnostic and Reference Laboratory in Fort Collins, Colorado, requested tissue sections from the cat’s liver and spleen and subsequently confirmed the presence of Y. pestis via PCR and tissue culture.
This project is classified as a public health surveillance activity conducted, supported, requested, ordered, required, or authorized by a public health authority (e.g., Oregon Health Authority). Per federal regulations, this activity does not constitute research involving human subjects and is therefore not subject to institutional review board review.
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