Case report: Resolution of a cutaneous infection with methicillin-resistant Staphylococcus pseudintermedius with topical therapy in a cat with pemphigus foliaceus

Abstract

Introduction Pemphigus foliaceus (PF) is the most common autoimmune skin disease in cats. Long-term immunosuppressive therapy increases susceptibility to opportunistic infections. Methicillin-resistant Staphylococcus pseudintermedius (MRSP) is an emerging multidrug-resistant pathogen in companion animals. Case description An 8-year-old spayed female Abyssinian cat with PF, managed with prednisolone and cyclosporine, developed localized superficial pyoderma caused by MRSP despite prior systemic antimicrobial therapy. Upon diagnosis of MRSP, systemic antibiotics were discontinued, and reinforcement of a strict regimen using 2% chlorhexidine and 10% povidone–iodine with topical gentamicin therapy led to complete resolution of the lesions. The patient achieved dermatologic remission without recurrence, allowing successful tapering and discontinuation of immunosuppressive therapy. Conclusions This case suggests that localized MRSP skin infections in selected feline patients receiving immunosuppressive therapy may be successfully managed with topical-based management alone. Such an approach supports antimicrobial stewardship in veterinary medicine, highlighting that topical therapy may be considered a reasonable first step in selected patients with localized superficial skin infections before escalating to systemic antimicrobials.