Cat bites always require check by doctor

• Reprints

Updated: January 28, 2012 8:01AM

Thirteen-year-old PJ was a finicky cat, lovable only on his terms.

One day, when owner Virginia Cappellini of Channahon was walking past him, PJ leaped out and bit her on the arm. The wound was small and PJ was an “inside” cat, so Cappellini cleaned the wound with soap, water and peroxide and continued on her way.

The next day, the bite was septic.

“When I got to the doctor’s office, my arm was red and swollen, from my forearm all the way up to my elbow,” Cappellini said. “I had to go get IV antibiotics.”

Occasionally, if a dog bite is mild and superficial, one can simply clean it well and “wait and see,” said Gail Steele, infection prevention nurse at Morris Hospital. Cat bites, however, must always be considered medical emergencies. This is especially true when they occur in the hand because that area has a richer blood supply.

“Their sharp little teeth are like little needles, and they inject bacteria right into soft tissue,” Steele said. “Cats’ mouths are full of bacteria and one— Bartonella—can also cause cat scratch disease. Kittens are more likely to carry this bacteria. As they get older, it decreases somewhat.”

Certainly, if a cat bites you, the first step is a good washing with soap and warm water. But because cat bites are notorious for quickly becoming serious, one should always follow up with a doctor. This is especially true, Steele said, for individuals with compromised immune systems, such as those with heart or lung disease and/or diabetes.

Typical initial treatment includes oral antibiotics, generally penicillin, or a combination of other antibiotics if the victim is allergic to penicillin. If the infection is mild, these should clear it up. If not, injections or intravenous antibiotics may be required, which certainly surprised Cappellini.

“People think that cats are so clean,” she said, “but they’re really not.”

Cappellini required hospitalization for four days of intravenous antibiotic treatments followed by two weeks or oral antibiotics at home. One night, several months later, Cappellini was again passing by PJ, where he and the dog were arguing. Again, PJ jumped out and bit Cappellini, this time on her shin.

Remembering the last incident, Cappellini washed it well and saw her doctor the next day.

She immediately began taking the antibiotics he prescribed her, but 24 hours later, her leg was swollen to twice its size. This time, the in-patient IV antibiotics did not work.

“My skin was very taut, very swollen, very shiny. This was much, much worse,” Cappellini said. “The doctor thought maybe the cat had hit the bone.”

A bone scan revealed an abscess, which was surgically removed, necessitating cutting through muscle down to the bone. Wound care for the next six weeks included packing and periodic trips to a wound care center, as well as two different antibiotics administered through a peripherally inserted central catheter, or PICC line.

“It healed from the inside out and it took seven months,” Cappellini said. “I have a scar and a herniated muscle from it. They think that maybe I’m allergic to the saliva in cats, or at least PJ’s, since the infections hit me so quickly.”

After the second bite, Cappellini’s daughter, who works at a veterinarian’s office, took PJ back to her apartment, just in case the dog was stressing the cat and causing the misbehavior.

“Last December, she was walking by him, and he jumped up and bit her,” Cappellini said. “He was put to sleep on Jan. 3 of this year.”