Actinomyces viscosus Isolation from the Skin of a Cat
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Israel Journal of Veterinary Medicine Vol. 69 (4) December 2014 239 Actinomyces viscosus from Cat Skin
INTRODUCTION
Te genus Actinomyces comprises aerobic or microaerobic,
Gram-positive, non-acid fast, flamentous, diphtheroidal rod
or coccobacillus-shaped organisms. Gross et al. (1) described
actinomycosis from contaminated penetrating wounds, such
as grass awns, quills, cactus spines, and other foreign bodies.
Classically, actinomycosis is a disease of cattle, but it also oc-
curs in other animal species including dogs, cats, cows, goats,
horses and in humans (2). Infection may become pathologic
due to the creation of suitable environment that is conducive
to the replication of previously existent commensal organ-
isms, penetrating foreign body or those introduced into the
wound secondarily to grooming (1), poor oral hygiene, den-
tal/periodontal disease, trauma and following oral surgical
procedures (3).
Foil (4) described actinomycosis of the skin and underly-
ing connective tissue, bone associated with puncture wounds
especially bite wounds, migrating plant foreign bodies, or
rarely severe periodontal disease with osteomyelitis. Routes
of dissemination of the infection are lymphatic and hema-
togenous (2).
Te causative organisms include a number of species of
Actinomyces, most frequently Actinomyces viscosus that are
normal inhabitants of the oral cavity of cats and dogs (4). Te
agent which causes pyogranulomatose infections have been
identifed as a pathogen in pets since 1972 (5).
Toracic (6), intra-abdominal (7), intraperitoneal (8), and
cutaneous or subcutaneous forms (9-11) have been reported.
Rarely pathogenic agents have been isolated from central
nervous system, lacrimal duct, prostate, mammary gland,
Actinomyces viscosus Isolation from the Skin of a Cat
Koenhemsi, L.,
1
* Sigirci, B.D.,
2
Bayrakal, A.,
1
Metiner, K.,
2
Gonul, R.,
1
and Ozgur, N.Y.
2
1
Istanbul University, Faculty of Veterinary Medicine, Department of Internal Medicine, Avcilar-Istanbul, 34320, Turkey.
2
Istanbul University, Faculty of Veterinary Medicine, Department of Microbiology, Avcilar-Istanbul, 34320, Turkey.
*
Corresponding Author: Dr. Lora Koenhemsi, Istanbul University, Faculty of Veterinary Medicine, Department of Internal Medicine, Avcilar-Istanbul,
Turkey 34320. Tel: +902124737070/17090, Email: lomekoh@istanbul.edu.tr
ABSTRACT
Actinomyces is an aerobic or microaerobic, Gram-positive, non-acid fast, flamentous, diphtheroidal rod or
coccobacillus-shaped bacteria. Actinomycosisis is seen mostly as a dental disease of cattle, however it also
occurs in other animal species such as dogs, cats, cows, goats and horses. Tis report describes a 1 year-old,
female, mixed-breed, indoor cat which developed a purulent exudate around the interdigital area for 6
months. Despite various antibacterial treatments the skin lesions of the cat deteriorated. Anamnesis revealed
that cat did not show any sign of pruritis however was eating a special diet for dermatologic disorders. Te
only sign on physical examination was a purulent exudate seen in the interdigital area. Hematological and
biochemical profles were within normal limits. Skin scrapes were negative for parasites and fungi. From the
wound swab, Actinomyces viscosus was identifed. According to the antibiotic susceptibility test, the isolate
was susceptible to amoxicillin and amoxicillin/clavulanic acid. Te cat received amoxicillin/clavulanic acid
(8.75 mg/kg BID, İM) for a week. After the treatment, there was no discharge around the interdigital area.
Tis case is of interest since Actinomyces viscosus has been rarely encountered in the skin of cats. Veterinarians
should include A. viscosus in the diferential diagnosis in case with dermal purulent discharge.
Keywords: Actinomyces viscosus; Cat; Feline; Dermatology.
Case Report
DECEMBER Book.indb 239 04/12/2014 10:57:18
Israel Journal of Veterinary Medicine Vol. 69 (4) December 2014 Koenhemsi, L. 240
ovary, liver, kidney, bladder, joints, skin and bone as well
as endocardium and pericardium (12). Te most common
clinical features of cutaneous and subcutaneous actinomy-
cosis which is uncommon in cats and dogs include abscess
formation, cellulitis, draining fstulous tracts, and ulcerated
dermal and subcutaneous nodules. Tere are characteristic
sulfur granules in draining sinuses. Te most common form
of disease is seen in the head, neck, thorax, abdomen and
distal parts in dogs, distal extremities and abdomen in cats
(1). It has been reported that canine interdigital actinomy-
cosis is especially likely to result from foxtail foreign body
(Hordeum murinum) penetration or introduced into a wound
by grooming (13). Free roaming cats are more often afected
simply because they have access to the felds where Hordeum
spp. is abundant.
Tis report is to the best knowledge of the authors the
frst report to describe an interdigital actinomycosis caused
by Actinomyces viscosus in the skin of a cat.
CASE REPORT
A 1 year-old, female, mixed, indoor cat presented to our clin-
ics with a 6 month history of a purulent exudation around
the interdigital area in the left hind leg. According to the
anamnesis this was the only dermatological problem in this
cat. Anamnesis revealed that referring veterinarian gave cat
the a special diet for this lesion. Despite diferent antibac-
terial treatments the skin lesions continued to deteriorate.
On physical examination only a purulent exudation was seen
in interdigital area. Hematological and biochemical profles
were within normal limits. Skin scrapes for parasitological
examination revealed negative results.
A swab of the wound was inoculated in Nurient Agar
containing 7% sheep blood and Nutrient Broth containing
horse serum and incubated microaerobically at 37°C for 48
hours. Gram staining was performed from the cultures and
conventional bacteriological methods were used for the iden-
tifcation (14). Te antibiotic susceptibility pattern of the
isolate was investigated by use of Kirby-Bauer disc difu-
sion method according to National Committee for Clinical
Laboratory Standards (15). For this purpose, antibiotic discs
comprising amoxicillin (25 µg), amoxicillin/clavulanic acid
(20 µg), cefoperazone (75 µg), ceftriaxone (30 µg), chloram-
phenicol (30 µg), ciprofoxacin (5 µg), enrofoxacin (5 µg),
erythromycin (15 µg), gentamicin (10 µg), linkomycin (10
µg), neomisin (30 µg), penicillin G (10 units), ampicillin/
sulbactam (10 µg), tetracycline (30 µg) (Oxoid, Hampshire,
England) were used.
Plucked hairs and scraped scales were examined for fun-
gal elements by direct microscopy in 10% potassium hydrox-
ide and were inoculated on Sabouraud Dextrose Agar (SDA)
with chloramphenicol and actidione and Dermatophyte Test
Medium (DTM). Te plates were incubated at 25°C for 3
weeks (16).
ß-hemolytic, small and smooth colonies were observed
as pure cultures on the blood agar plates after 24 hours of
incubations. Gram staining of the colonies revealed Gram
positive coccobacilli. Te isolate according to biochemical
properties was identifed as Actinomyces viscosus (Table 1).Te
examination of plucked hairs and scraped scales for fungal
elements was negative. At the end of the incubation period
fungal growth was not observed.
According to antibiotic susceptibility tests, the isolate
was susceptible to amoxicillin and amoxicillin/clavulanic acid
(Table 2), which it received at 8.75 mg/kg BID İM, for a
week. According to the owner, the patient’s condition seemed
Table 1: Biochemical properties of the isolate
Gram staining Gram positive Gram staining Gram positive
Oxidase - Arabinose -
Catalase + Dulcitol -
Motility - Fructose +
O-F test
Reaction
Oxidative + Galactose +
Fermentative + Glucose +
Unreactive Inositol -
Hemolysis - Inulin -
Methyl Red + Xylose -
Indol - Lactose +
Nitrate + Maltose +
Citrate - Mannitole -
Urease - Mannose +
Lysin oxidation + Mellibiose +
Arginin oxidation - Rafnose +
Ornithin oxidation + Rhamnose -
Gelatinase - Ribose -
Phenylalanine - Salicin -
Growth on 6,5%NaCl - Sellobiose -
CAMP - Sorbitole -
Malonate - Sorbose -
Esculin + Sucrose +
Acid from Adonitol - Trehalose -
- : Negative, +: Positive
Case Report
DECEMBER Book.indb 240 04/12/2014 10:57:18
Israel Journal of Veterinary Medicine Vol. 69 (4) December 2014 241 Actinomyces viscosus from Cat Skin
to improve within the next few days. A week later there was
no discharge in the interdigital area of the cat.
Table 2: Antibiotic susceptibilities of the isolates
Antimicrobial agent S I R
Amoxicillin (25 µg) S
Amoxicillin/Clavulanicacid (30 µg) S
Ampicillin/Sulbactam (20 µg) S
Cefoperazone (75 µg) R
Ceftriaxone (30µg) R
Chloramphenicol (30 µg) R
Ciprofoxacin (5 µg) R
Enrofoxacin (5 µg) R
Erythromycin (15 µg) R
Gentamycin (10 µg) R
Linkomycin (2 µg) R
Neomysin ( 30 µg) R
Penicillin (10 units) R
Tetracycline (30 µg) R
S: Susceptible; I: Intermediate susceptible; R: Resistant
DISCUSSION
Te most common locations of actinomycosis are neck, abdo-
men, thorax, and other areas such as mandible, endocardium.
Also rare features of A. viscosus can be isolated from central
nervous system, prostate, ovary, liver, kidney, bladder, joints,
skin, bone, endocardium, and pericardium in human being
(12). Bestetti et al. (9) isolated A. viscosus from the infamma-
tory tissues of a 3 year old female domestic cat which had a
suppurative granulomatous lesion of the tail and sacral area
which penetrated into the epidural space, causing paraple-
gia. Te present case report is to the best knowledge of the
authors the frst case describing A. viscosus isolated from in-
terdigital area of a cat.
Murakami et al. (10) have identifed A. viscosus from the
left inframandibular region of a male 4 year-old cat. Te or-
ganisms in the abscess stained positive by the Gram’s and
was identifed by the immunoperoxidase method. On the
physical examination there was no wound on the surface of
the skin abscess. Terefore they reported that the infection
was probably endogenous occurring as a result of a previously
reported stomatitis.
Isolation of A. viscosusis rare in cats and dogs with an in-
creased incidence in hunter dogs (17). Kirprenstejin et al. (2)
isolated Actinomyces spp. from cutaneous lesions in 27 (60%)
dogs out of 45 dogs. Of the 27 Actinomyces spp., A. viscosus
was isolated in 11 (41%) of dogs. Also the authors reported
that skin wounds and tissue injuries probably resulted in a
suitable environment for bacterial reproduction.
In present case, interdigital actinomycosis developed in
a cat. Although we did not fnd any evidence on clinical
examination we hypothesized that a foreign body might
have resulted in the purulent exudation. Because of the
meticulous nature of cats there is a reduced possibility for
penetration of thorny plants and therefore clinically thorny
plant wounds are rarely seen. Te fndings in this case should
prompt clinicians to consider diferent kinds of bacteria such
as Actinomyces viscosus as the diferential diagnosis of skin
diseases in cats with purulent exudate.
CONFLI CT OF I NTERESTS
No conficts of interest have been declared. Tis case report was
presented at the 10
th
National Internal Medicine Congress,
Kapadokya, Turkey
REFERENCES
1. Gross, T.L., Ihrke, P.J., Walder, E.S. and Afolter, V.K.: Skin dis-
eases of the dog and cat: clinical and histopathologic diagnosis.
Blackwell Science Limited, UK. pp 272-275, 2005.
2. Kirpensteijn, J. and Fingland, R.B.: Cutaneous actinomyco-
sis and nocardiosis in dogs: 48 cases (1980-1990). JAVMA.
201:917-920, 1992.
3. Actinomycosis 2011 Available at:http://www.gopetsamerica.
com/dog-health/actinomycosis.aspx. Accessed June 2012.
4. Foil, C.S.: Nodules, ulcers and draining tracts in the cat difer-
ential diagnosis and clinical features of important causes. In:
II Congresso Internacional de medicina Felina, Rio de Janeiro,
14-17 July 2001.
5. Georg, L.K., Brown, J.M., Baker, H.J. and Cassell, G.H.: Actin-
omyces viscosusas an agent of actinomycosis in the dog. AVJR.
33:1457–1470, 1972.
6. Davenport, A.A., Carter, G.R. and Patterson, M.J.: Identifca-
tion of Actinomyces viscosus from canine infections. J Clin. Micro-
biol.1:75-78, 1975.
7. Sharman, M.J., Goh, C.S., Kuipers von Lande, R.G. and Hodg-
son, J.L.: Intra-abdominal actinomycetoma in a cat. J. Fel. Med.
Surg. 11:701-705; 2009.
8. Kawamura, N., Shimada, A., Morita, T., Murakami, S., Azuma,
R., Fujiwara, M. and Fujiwara, A.: Intraperitoneal actinomycosis
in a cat. Vet. Rec. 157:593-594, 2005.
9. Bestetti, G., Bühlmann, V., Nicolet, J. and Fankhauser, R.: Para-
plegia due to Actinomyces viscosus infection in a cat. Acta Neuro-
pathologica. 39:231-235, 1977.
10. Murakami, S., Yamanishi, M.W. and Azuma, R.: Lymph
node abscess due to Actinomyces viscosus in a cat. J. Vet. Med.
Sci.59:1079-1080, 1997.
Case Report
DECEMBER Book.indb 241 04/12/2014 10:57:18
Israel Journal of Veterinary Medicine Vol. 69 (4) December 2014 Koenhemsi, L. 242
11. Koutinas, C.K., Papazoglou, L.G., Saridomichelakis, M.N., Kouti-
nas, A.F. and Patsikas, M.N.: Caudal mediastinal abscess due to a
grass awn (Hordeums spp.) in a cat. J. Fel. Med. Surg. 5:43-46, 2003.
12. Zylber, L.J. and Jordan, H.V.: Development of a selective medium
for detection and enumeration of Actinomyces viscosus and Actino-
myces naeslundii in dental plaque. J. Clin.Microbiol. 15:253-259,
1982.
13. Brennan, K.E. and Ihrke, P.J.: Grass awn migration in dogs and
cats: a retrospective study of 182 cases. J. Am. Vet. Med. Assoc.
182:1201-1204, 1983.
14. Quinn, P.J., Carter, M.E., Markey, B.K. and Carter, G.R.: Clini-
cal Veterinary Microbiology. Harcourt Publishers Limited, 1999.
15. Clinical and Laboratory Standards Institute. Performance Stand-
ards for Antimicrobial Susceptibility Testing; Sixteenth Informa-
tional Supplement. CLSI document M100-S16 [ISBN 1-56238-
588-7]. Clinical and Laboratory Standards Institute, Pennsylva-
nia USA 2006
16. De Hoog, G.S., Guarro, J., Gené,J. and Figueras, M.J. (eds): Atlas
of Clinical Fungi, 2nd ed. Utrecht, Te Netherlands and Univer-
sity Rovirai Virgili, Reus, Spain: Centraal bureau voor Schimmel
cultures, pp:39-42, 2000.
17. Medleau, L. and Hnilica, K.A.: Small animal dermatology: A
color atlas and therapeutic guide, Saunders Elsevier, p. 50-51,
2006.
CORRECTION
In error, in an article published in Volume 69 (1), 2014, entitled: “Heart Base Abscess Caused by Prevotella oralis in a
Dog”, one of the authors was omitted. Dr. Emmanuel Loeb’s name has now been added with details of his afliation.
Te name of the article and the list of authors now reads:
Heart Base Abscess Caused by Prevotella oralis in a Dog
Joseph, R.,
1
Ohad, D.,
2
Dank, G.,
3
Blum, S.,
4
Loeb., E.
5
and Milgram, J.
1
1
Hebrew University Jerusalem, Koret School of Veterinary Medicine, Department of Surgery, Jerusalem 91905, Israel.
2
Hebrew University Jerusalem, Koret School of Veterinary Medicine, Department of Cardiology, Jerusalem 91905, Israel.
3
Hebrew University Jerusalem, Koret School of Veterinary Medicine, Department of Oncology, Jerusalem 91905, Israel.
4
Kimron Veterinary Institute, Department of Veterinary Bacteriology, Beit Dagan 50250, Israel.
5
Kimron Veterinary Institute, Department of Veterinary Pathology, Beit Dagan 50250, Israel.
Case Report
DECEMBER Book.indb 242 04/12/2014 10:57:18
Israel Journal of Veterinary Medicine Vol. 69 (4) December 2014 239 Actinomyces viscosus from Cat Skin
INTRODUCTION
Te genus Actinomyces comprises aerobic or microaerobic,
Gram-positive, non-acid fast, flamentous, diphtheroidal rod
or coccobacillus-shaped organisms. Gross et al. (1) described
actinomycosis from contaminated penetrating wounds, such
as grass awns, quills, cactus spines, and other foreign bodies.
Classically, actinomycosis is a disease of cattle, but it also oc-
curs in other animal species including dogs, cats, cows, goats,
horses and in humans (2). Infection may become pathologic
due to the creation of suitable environment that is conducive
to the replication of previously existent commensal organ-
isms, penetrating foreign body or those introduced into the
wound secondarily to grooming (1), poor oral hygiene, den-
tal/periodontal disease, trauma and following oral surgical
procedures (3).
Foil (4) described actinomycosis of the skin and underly-
ing connective tissue, bone associated with puncture wounds
especially bite wounds, migrating plant foreign bodies, or
rarely severe periodontal disease with osteomyelitis. Routes
of dissemination of the infection are lymphatic and hema-
togenous (2).
Te causative organisms include a number of species of
Actinomyces, most frequently Actinomyces viscosus that are
normal inhabitants of the oral cavity of cats and dogs (4). Te
agent which causes pyogranulomatose infections have been
identifed as a pathogen in pets since 1972 (5).
Toracic (6), intra-abdominal (7), intraperitoneal (8), and
cutaneous or subcutaneous forms (9-11) have been reported.
Rarely pathogenic agents have been isolated from central
nervous system, lacrimal duct, prostate, mammary gland,
Actinomyces viscosus Isolation from the Skin of a Cat
Koenhemsi, L.,
1
* Sigirci, B.D.,
2
Bayrakal, A.,
1
Metiner, K.,
2
Gonul, R.,
1
and Ozgur, N.Y.
2
1
Istanbul University, Faculty of Veterinary Medicine, Department of Internal Medicine, Avcilar-Istanbul, 34320, Turkey.
2
Istanbul University, Faculty of Veterinary Medicine, Department of Microbiology, Avcilar-Istanbul, 34320, Turkey.
*
Corresponding Author: Dr. Lora Koenhemsi, Istanbul University, Faculty of Veterinary Medicine, Department of Internal Medicine, Avcilar-Istanbul,
Turkey 34320. Tel: +902124737070/17090, Email: lomekoh@istanbul.edu.tr
ABSTRACT
Actinomyces is an aerobic or microaerobic, Gram-positive, non-acid fast, flamentous, diphtheroidal rod or
coccobacillus-shaped bacteria. Actinomycosisis is seen mostly as a dental disease of cattle, however it also
occurs in other animal species such as dogs, cats, cows, goats and horses. Tis report describes a 1 year-old,
female, mixed-breed, indoor cat which developed a purulent exudate around the interdigital area for 6
months. Despite various antibacterial treatments the skin lesions of the cat deteriorated. Anamnesis revealed
that cat did not show any sign of pruritis however was eating a special diet for dermatologic disorders. Te
only sign on physical examination was a purulent exudate seen in the interdigital area. Hematological and
biochemical profles were within normal limits. Skin scrapes were negative for parasites and fungi. From the
wound swab, Actinomyces viscosus was identifed. According to the antibiotic susceptibility test, the isolate
was susceptible to amoxicillin and amoxicillin/clavulanic acid. Te cat received amoxicillin/clavulanic acid
(8.75 mg/kg BID, İM) for a week. After the treatment, there was no discharge around the interdigital area.
Tis case is of interest since Actinomyces viscosus has been rarely encountered in the skin of cats. Veterinarians
should include A. viscosus in the diferential diagnosis in case with dermal purulent discharge.
Keywords: Actinomyces viscosus; Cat; Feline; Dermatology.
Case Report
DECEMBER Book.indb 239 04/12/2014 10:57:18
Israel Journal of Veterinary Medicine Vol. 69 (4) December 2014 Koenhemsi, L. 240
ovary, liver, kidney, bladder, joints, skin and bone as well
as endocardium and pericardium (12). Te most common
clinical features of cutaneous and subcutaneous actinomy-
cosis which is uncommon in cats and dogs include abscess
formation, cellulitis, draining fstulous tracts, and ulcerated
dermal and subcutaneous nodules. Tere are characteristic
sulfur granules in draining sinuses. Te most common form
of disease is seen in the head, neck, thorax, abdomen and
distal parts in dogs, distal extremities and abdomen in cats
(1). It has been reported that canine interdigital actinomy-
cosis is especially likely to result from foxtail foreign body
(Hordeum murinum) penetration or introduced into a wound
by grooming (13). Free roaming cats are more often afected
simply because they have access to the felds where Hordeum
spp. is abundant.
Tis report is to the best knowledge of the authors the
frst report to describe an interdigital actinomycosis caused
by Actinomyces viscosus in the skin of a cat.
CASE REPORT
A 1 year-old, female, mixed, indoor cat presented to our clin-
ics with a 6 month history of a purulent exudation around
the interdigital area in the left hind leg. According to the
anamnesis this was the only dermatological problem in this
cat. Anamnesis revealed that referring veterinarian gave cat
the a special diet for this lesion. Despite diferent antibac-
terial treatments the skin lesions continued to deteriorate.
On physical examination only a purulent exudation was seen
in interdigital area. Hematological and biochemical profles
were within normal limits. Skin scrapes for parasitological
examination revealed negative results.
A swab of the wound was inoculated in Nurient Agar
containing 7% sheep blood and Nutrient Broth containing
horse serum and incubated microaerobically at 37°C for 48
hours. Gram staining was performed from the cultures and
conventional bacteriological methods were used for the iden-
tifcation (14). Te antibiotic susceptibility pattern of the
isolate was investigated by use of Kirby-Bauer disc difu-
sion method according to National Committee for Clinical
Laboratory Standards (15). For this purpose, antibiotic discs
comprising amoxicillin (25 µg), amoxicillin/clavulanic acid
(20 µg), cefoperazone (75 µg), ceftriaxone (30 µg), chloram-
phenicol (30 µg), ciprofoxacin (5 µg), enrofoxacin (5 µg),
erythromycin (15 µg), gentamicin (10 µg), linkomycin (10
µg), neomisin (30 µg), penicillin G (10 units), ampicillin/
sulbactam (10 µg), tetracycline (30 µg) (Oxoid, Hampshire,
England) were used.
Plucked hairs and scraped scales were examined for fun-
gal elements by direct microscopy in 10% potassium hydrox-
ide and were inoculated on Sabouraud Dextrose Agar (SDA)
with chloramphenicol and actidione and Dermatophyte Test
Medium (DTM). Te plates were incubated at 25°C for 3
weeks (16).
ß-hemolytic, small and smooth colonies were observed
as pure cultures on the blood agar plates after 24 hours of
incubations. Gram staining of the colonies revealed Gram
positive coccobacilli. Te isolate according to biochemical
properties was identifed as Actinomyces viscosus (Table 1).Te
examination of plucked hairs and scraped scales for fungal
elements was negative. At the end of the incubation period
fungal growth was not observed.
According to antibiotic susceptibility tests, the isolate
was susceptible to amoxicillin and amoxicillin/clavulanic acid
(Table 2), which it received at 8.75 mg/kg BID İM, for a
week. According to the owner, the patient’s condition seemed
Table 1: Biochemical properties of the isolate
Gram staining Gram positive Gram staining Gram positive
Oxidase - Arabinose -
Catalase + Dulcitol -
Motility - Fructose +
O-F test
Reaction
Oxidative + Galactose +
Fermentative + Glucose +
Unreactive Inositol -
Hemolysis - Inulin -
Methyl Red + Xylose -
Indol - Lactose +
Nitrate + Maltose +
Citrate - Mannitole -
Urease - Mannose +
Lysin oxidation + Mellibiose +
Arginin oxidation - Rafnose +
Ornithin oxidation + Rhamnose -
Gelatinase - Ribose -
Phenylalanine - Salicin -
Growth on 6,5%NaCl - Sellobiose -
CAMP - Sorbitole -
Malonate - Sorbose -
Esculin + Sucrose +
Acid from Adonitol - Trehalose -
- : Negative, +: Positive
Case Report
DECEMBER Book.indb 240 04/12/2014 10:57:18
Israel Journal of Veterinary Medicine Vol. 69 (4) December 2014 241 Actinomyces viscosus from Cat Skin
to improve within the next few days. A week later there was
no discharge in the interdigital area of the cat.
Table 2: Antibiotic susceptibilities of the isolates
Antimicrobial agent S I R
Amoxicillin (25 µg) S
Amoxicillin/Clavulanicacid (30 µg) S
Ampicillin/Sulbactam (20 µg) S
Cefoperazone (75 µg) R
Ceftriaxone (30µg) R
Chloramphenicol (30 µg) R
Ciprofoxacin (5 µg) R
Enrofoxacin (5 µg) R
Erythromycin (15 µg) R
Gentamycin (10 µg) R
Linkomycin (2 µg) R
Neomysin ( 30 µg) R
Penicillin (10 units) R
Tetracycline (30 µg) R
S: Susceptible; I: Intermediate susceptible; R: Resistant
DISCUSSION
Te most common locations of actinomycosis are neck, abdo-
men, thorax, and other areas such as mandible, endocardium.
Also rare features of A. viscosus can be isolated from central
nervous system, prostate, ovary, liver, kidney, bladder, joints,
skin, bone, endocardium, and pericardium in human being
(12). Bestetti et al. (9) isolated A. viscosus from the infamma-
tory tissues of a 3 year old female domestic cat which had a
suppurative granulomatous lesion of the tail and sacral area
which penetrated into the epidural space, causing paraple-
gia. Te present case report is to the best knowledge of the
authors the frst case describing A. viscosus isolated from in-
terdigital area of a cat.
Murakami et al. (10) have identifed A. viscosus from the
left inframandibular region of a male 4 year-old cat. Te or-
ganisms in the abscess stained positive by the Gram’s and
was identifed by the immunoperoxidase method. On the
physical examination there was no wound on the surface of
the skin abscess. Terefore they reported that the infection
was probably endogenous occurring as a result of a previously
reported stomatitis.
Isolation of A. viscosusis rare in cats and dogs with an in-
creased incidence in hunter dogs (17). Kirprenstejin et al. (2)
isolated Actinomyces spp. from cutaneous lesions in 27 (60%)
dogs out of 45 dogs. Of the 27 Actinomyces spp., A. viscosus
was isolated in 11 (41%) of dogs. Also the authors reported
that skin wounds and tissue injuries probably resulted in a
suitable environment for bacterial reproduction.
In present case, interdigital actinomycosis developed in
a cat. Although we did not fnd any evidence on clinical
examination we hypothesized that a foreign body might
have resulted in the purulent exudation. Because of the
meticulous nature of cats there is a reduced possibility for
penetration of thorny plants and therefore clinically thorny
plant wounds are rarely seen. Te fndings in this case should
prompt clinicians to consider diferent kinds of bacteria such
as Actinomyces viscosus as the diferential diagnosis of skin
diseases in cats with purulent exudate.
CONFLI CT OF I NTERESTS
No conficts of interest have been declared. Tis case report was
presented at the 10
th
National Internal Medicine Congress,
Kapadokya, Turkey
REFERENCES
1. Gross, T.L., Ihrke, P.J., Walder, E.S. and Afolter, V.K.: Skin dis-
eases of the dog and cat: clinical and histopathologic diagnosis.
Blackwell Science Limited, UK. pp 272-275, 2005.
2. Kirpensteijn, J. and Fingland, R.B.: Cutaneous actinomyco-
sis and nocardiosis in dogs: 48 cases (1980-1990). JAVMA.
201:917-920, 1992.
3. Actinomycosis 2011 Available at:http://www.gopetsamerica.
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CORRECTION
In error, in an article published in Volume 69 (1), 2014, entitled: “Heart Base Abscess Caused by Prevotella oralis in a
Dog”, one of the authors was omitted. Dr. Emmanuel Loeb’s name has now been added with details of his afliation.
Te name of the article and the list of authors now reads:
Heart Base Abscess Caused by Prevotella oralis in a Dog
Joseph, R.,
1
Ohad, D.,
2
Dank, G.,
3
Blum, S.,
4
Loeb., E.
5
and Milgram, J.
1
1
Hebrew University Jerusalem, Koret School of Veterinary Medicine, Department of Surgery, Jerusalem 91905, Israel.
2
Hebrew University Jerusalem, Koret School of Veterinary Medicine, Department of Cardiology, Jerusalem 91905, Israel.
3
Hebrew University Jerusalem, Koret School of Veterinary Medicine, Department of Oncology, Jerusalem 91905, Israel.
4
Kimron Veterinary Institute, Department of Veterinary Bacteriology, Beit Dagan 50250, Israel.
5
Kimron Veterinary Institute, Department of Veterinary Pathology, Beit Dagan 50250, Israel.
Case Report
DECEMBER Book.indb 242 04/12/2014 10:57:18
Journal:
