It was just a small scratch from a cat - but six days later my heart stoppedBy David Hurst
Last updated at 10:41 PM on 12th December 2011
Bacteria from the claw had entered his bloodstream, triggering septicaemia.
Jon recalls: ‘I was in the kitchen when the cat jumped from our oven on to my foot and left two 6cm scratches. After putting TCP and a bandage on, I thought nothing more of it.’
It multiplied, settling on the aortic valve in his heart — which controls the flow of blood around the rest of the body.
Two days later Jon, 44, thought he was coming down with flu. The day after that, he felt so ill he took to his bed.
‘I’m usually resilient — but I was surprised at how much this “flu” had knocked me for six,’ says Jon, who lives with his wife Stephanie and their three children near Okehampton, Devon.
The next night he was woken by a pulsating pain in his left ring finger — by the next morning it was swollen and had turned purple.
Even then, market wholesaler Jon wasn’t unduly concerned, thinking he might have damaged it at work. But swellings like this, away from the original site of injury, is a typical symptom of septicaemia (or blood poisoning).
Septicaemia occurs when bacteria multiply in the blood, causing widespread inflammation that damages vital organs. If not treated promptly, septic shock can develop, where bacterial toxins cause blood pressure to plummet.
Eventually, the organs start to fail, and it results in death in more than half of patients.
‘But six days after being scratched, I was jaundiced and very unwell. I had a raging fever and was very weak.’
His family became so concerned they called an ambulance and Jon was rushed to hospital.
‘By this point I was drifting in and out of consciousness, and my memory of being admitted is hazy,’ he says.
Jon was taken to intensive care, where tests showed his heart, lungs, liver and kidney were about to fail — at one stage his heart stopped beating for a few seconds and had to be restarted.
He was told his aortic valve needed replacing.
It is important to pay attention to scratches, no matter how small, advises Dr Suranjith Seneviratne, an immunologist at the Royal Free Hospital, London.
An infected scratch will usually start to look red and infected, and the lymph node will start to swell near the wound after ten days. This will be followed by fever, fatigue, headaches and, in some cases, a loss of appetite, enlarged spleen and sore throat.
Worryingly, Dr Seneviratne adds: ‘A scratch can look like it’s healing, but the bacteria could have travelled to another site. Symptoms can often be seen away from the scratch, because of the incubation period — usually a few days — as the bacteria multiply and divide.’
The bacteria can settle on the heart, liver, brain, kidney and lungs, with those with a low immune system — such as the elderly, babies or someone with an existing illness such as cancer or diabetes — being most at risk.
Certain medications can suppress the immune system, including chemotherapy and steroids (used for conditions including rheumatoid arthritis and multiple sclerosis).
‘With otherwise healthy people, normally their immune system would kill off the bacteria,’ says Dr Seneviratne.
Jon had been diagnosed with a heart murmur in his mid-30s, caused by a weak valve, and doctors believe that bacteria from the cat’s claw had settled on this weak spot.
It’s not just animal scratches that can cause problems — so, too, can splinters or thorns.
Debbie Penwill, who runs a livery stable, developed a bacterial infection after scratching herself at a wedding reception.
‘Someone messing about lobbed a chair cushion that was backed by a thin piece of wood,’ says Debbie, 29, from Tavistock, Devon.
‘It hit me between my ankle and knee, causing a painful bump and scratch just a couple of millimetres long. It didn’t look deep, so I didn’t wash it and thought nothing more of it.’
But six days after the wedding in September, she woke up with a rash all over her body.
‘I’d had a flu-like virus a few weeks before and put it down to that.
‘But the next day the rash was really red and I was sick. I went to the local hospital where one doctor said it could be scarlet fever, but his colleague said it wasn’t.’
She was given moisturising cream, as her skin felt dry. But that night she couldn’t sleep because of the pain. ‘It was like I’d been dragged through stinging nettles — itchy and burning. I was scared as I didn’t have a clue what it was.’
At 4am she went to Derriford Hospital in Plymouth.
‘I had a blood test and nine different doctors had a look at me. They decided it wasn’t an allergy, but they still didn’t know what it was.’
Debbie was sent home with steroid tablets and some other skin creams.
In a couple of days the rash had calmed down, but then it merged into purple and black patches — which she later discovered was due to bacterial toxins circulating in her body.
Debbie’s skin became sore and tender for a few days.
‘I felt like a 90-year-old, as I was in pain when I walked and could barely get out of bed,’ she says.
Debbie saw another doctor after about three weeks, and by then her symptoms were a faded rash. A blood test showed she’d had the streptococcus bacteria.
It must have entered her bloodstream through the small scratch — the rash was scarlatina, a bacterial illness linked to scarlet fever. It develops only if someone is susceptible to the toxins produced by the streptococcus bacteria.
‘I had to take three weeks off work, and as I’m self-employed I lost a lot of money,’ she says.
‘My skin is still peeling nine weeks later. But I’m just glad to know what it was. I’ll definitely clean any scratches from now on.’
THE DANGER SIGNS OF SEPTICAEMIA
‘The dirtier and deeper the scratch the more likely there will be an infection,’ explains Hilary Longhurst, consultant immunologist at St Bartholomew’s Hospital, London.
‘The classic case we might see is the old lady doing her roses who gets a thorn scratch after putting manure down.’
She adds: ‘With septicaemia, look out for hot swelling, pain, feeling unwell, or swollen lymph glands near the scratch. If it’s not improving go to your doctor or A&E immediately.
‘Depending on its severity, oral or intravenous antibiotics will usually clear up an infection, but the sooner it’s caught the better.’