• Walter Johannes Smits, Heinz-Hubert Feucht, Frank Oellig, and Bernhard Zöllner.
• Praxis für Allgemeinmedizin, Hamminkeln.
• Dtsch. Med. Wochenschr. 2020 Oct 1; 145 (21): 1559-1561.

HistoryA 60 years old woman experienced a cat scratch 34 months ago on the left eyelid. Chronic, progredient skin lesions and headache developed. Treatments with cortisone, pimecrolimus, pregabalin and metamizole were not successful. After 24 months the patient complained of severe bulbus pain in the left eye, increased eye movement pain, and high photosensitivity. There were granulomatous papules in the area of the eye.Findings And DiagnosisThe interdisciplinary examination findings and clinical-chemical parameters were inconspicuous. A biopsy of the eyelid area revealed the detection of Delftia acidovorans by bacterial 16S-rRNA-PCR.Therapy And CourseTreatment with piperacillin/tazobactam 3 × 4.5 g/d IV for 10 days led to rapid clinical improvement, so that the patient could be discharged after 11 days. After additional 10 months, she had no relapse and was free of complaints.ConclusionsD. acidovorans has not yet appeared as a zoonotic pathogen but should be included in the case of injury by animals in the differential diagnostic considerations.Thieme. All rights reserved.

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