Elimination of bacteremia caused by Mycoplasma haemofelis following dual therapy with doxycycline and ciprofloxacin

Mycoplasma haemofelis is small wall-less bacteria with worldwide prevalence that infect erythrocytes and without effective treatment may cause death. The failure of most antibiotic therapy protocols to effective elimination of this potentially zoonotic agent highlights the necessity to determine an optimal treatment. A two-year-old domestic shorthair cat was referred to veterinary hospital of Urmia University with symptoms of lethargy, fever, jaundice and anemia. Clinical findings, the results of Giemsa stained blood smear and polymerase chain reaction on 16S rRNA confirmed the infection caused by M. haemofelis. Doxycycline (10 mg/kg PO q24h) was administered for 4 weeks. However, no clinical improvement was achieved and persistence of M. haemofelis infection was observed on cytology. After starting dual therapy with the addition of ciprofloxacin (20 mg/kg PO q24h) for two weeks, elimination of bacteremia was confirmed by cytological re-examination and negative result of polymerase chain reaction as the preferred diagnostic method. According to the authors' knowledge, this is the first report of bacteremia elimination caused by M. haemofelis using dual treatment with doxycycline and ciprofloxacin. It is suggested that this protocol be tried for more feline patients.