CAT BITE REPORT

A 73 year old customer came into the store on 3/30/21 and presented an ugly bite on his left hand that he just received from his domestic cat. Customer was not a patient at the pharmacy.

Customer was told by the pharmacist that animal bites, particularly cat bites, are serious and can lead to serious problems especially if the infection spreads into the blood system. Customer was advised to immediately go to the ER or to an urgent care facility.

For whatever reason (insurance, travel restrictions, etc.) the customer did not want to go for immediate care. Asked the pharmacist what other options were available. Pharmacist asked who his primary care physician (PCP) was. Pharmacist agreed to provide a 24-hour intervention strategy until communication could be made with his PCP.

Upon further examination (Slide one), the pharmacist observed that the whole hand up to the wrist/arm area and all fingers were swollen and that an active infection was present at the top of his second finger. A fever of 101.1 degree Fahrenheit was observed, but no sign of expanding infection up the front of the arm or behind the arm was observed.

Pharmacist requested that the patient clean the wound, apply antiseptic & then soak the entire hand in Epsom salt (magnesium sulfate) for 20 minutes. Patient was told not to force the active infection on top of the second finger to break. Rather, the patient was instructed to apply a drawing ointment (Ichthammol) to the wound and to then apply silver ointment to the wound and any other open skin areas. He was told to repeat this process three times a day. Further, the patient was asked to take one teaspoonful of Colloidal Silver (500 PPM) twice a day or every 12 hours to help kill infection & one teaspoonful of Elderberry Elixir every 4 hours to help boost his immune system. He was told to take ibuprofen for any pain & to stay fully hydrated.

On 3/31/21 the pharmacist was able to email PCP with a picture of the bite wound. PCP & pharmacist reviewed the case and what treatment plan had been implemented the day before. PCP then sent in a prescription for a 5 day supply of azithromycin. Patient picked on prescription on 3/31/21 and renewed again on 4/5/21. On 3/31/21 patients fever had been reduced to 99.8 degrees Fahrenheit.

Pharmacist and patient stayed in contact to review success. Patient stayed in contact with his PCP. On 4/17/21 or 18 days after cat bite, the beginning of healing could be observed (Slide two). The active infection on the top of the second finger had broken, but the area remained suspicious of infection. Most promising, the area around the bite site was turning purple which is a key first sign of healing. Crusting and skin peeling was occurring throughout the hand and fingers areas. Pain, swelling & redness was significantly reduced especially in all fingers. Patient requested to continue external application of silver to the wound area, to continue taking Elderberry Elixir and to stay hydrated to encourage the production of new skin cells beneath the skin.

On 4/20/21 pharmacist observed that the original infection at the top of the second finger showed no sign of infection and was healing/scabbing as anticipated. However, a new potential infection was observed below the original infection. This area had been covered by scabbing on 4/1/21 (Slide 3). Patient was requested to continue silver application to the second wound and to begin taking Colloidal Silver internally again twice a day.

On 4/26/21 inflammation throughout the hand and all fingers has been greatly reduced (Slide 4). Purple area around the bite site was starting to turn pink or the beginning of evidence of new skin cell production. It was observed that the first infection wound was totally healed and that second potential infection wound had drained and had no evidence of infection. As expected, the skin throughout the hand area continued to shed as new skin cells were being created.

On 5/22/21 or 7 weeks after cat bite (Slide 5) swelling was totally gone, wounds all healed & crusting & peeling all gone. Pink or new skin production now dominates. Success story.

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