Abstract
Mycobacterial infections are a major concern in veterinary medicine because of the difficulty achieving an etiological diagnosis, the challenges and concerns of treatment, and the potential zoonotic risk. Mycobacterium kansasii, a slow-growing non-tuberculous mycobacteria, causes disease in both humans and animals. While infections have been well described in humans, where it may be misdiagnosed as tuberculosis, there are fewer reports in animals. Only four cases have been reported in the domestic cat. This case report describes systemic M. kansasii infection in two sibling indoor-only cats that presented two and half years apart with cutaneous disease that was found to be associated with osteolytic and pulmonary pathology. Infection with M. kansasii was confirmed in both cats by polymerase chain reaction on fine-needle aspirate of a lumbosacral soft tissue mass in one cat and on a tissue punch biopsy of a skin lesion in the other; interferon-gamma release assay inferred M. avium-complex and M. tuberculosis-complex infection in the two cats, respectively. Both patients made a full recovery following antimicrobial therapy with rifampicin, azithromycin, and pradofloxacin (plus N-acetyl cysteine in cat 2). This report highlights successful treatment of systemic M. kansasii mycobacteriosis in the cat and the challenge of accurately diagnosing this infection.
Highlights
Mycobacterial infections in cats are increasingly recognised throughout many parts of the world, including Great Britain [1], continental Europe [2,3,4,5], Australia [6], and North America [7]
The non-tuberculous mycobacteria (NTM) have been categorized based on their growth characteristics [13]; some species of mycobacteria cannot be cultivated in Pathogens 2020, 9, 959; doi:10.3390/pathogens9110959
An eight-year-old male neutered Domestic Shorthair (DSH) cat presented in February 2017 to the Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies (RDSVS), The University of Edinburgh, for investigation of over-grooming of the distal tail and an associated chronic non-resolving cutaneous lesion caused by self-inflicted trauma; partial amputation by the referring veterinarian surgeon (RVS) to remove the affected part of the tail had not resolved the chewing, and resulted in the cat starting to chew a new area of the tail
Summary
Mycobacterial infections in cats are increasingly recognised throughout many parts of the world, including Great Britain [1], continental Europe [2,3,4,5], Australia [6], and North America [7]. Mycobacteria can be divided into two groups: the non-tuberculous mycobacteria (NTM) [8], and the Mycobacterium (M.) tuberculosis-complex (MTBC), which includes the causative agents of tuberculosis (TB) in cats, i.e., M. bovis and M. microti—the vole bacillus [1,9]. NTM based upon genetic similarity rather than phenotypic and growth characteristics; this has allowed for the identification of previously unrecognized mycobacterial species [16,17]. Mycobacterium kansasii, a slow-growing NTM [18], was first isolated in 1953 [19]. Since it has been identified as a major pathogen of people, where it can cause pulmonary disease resembling
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