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Musculoskeletal and Sports Medicine

New Onset Carpal Tunnel Syndrome Associated with Cat Bite: A Case Report

Friday, October 24, 2025
8:00 AM - 9:15 AM MT
Location: Kiosk 3

    Primary Author(s)

  • Courtney L. Chamberlin, DO

    PM&R PGY-2
    University of Arkansas for Medical Sciences PM&R Program
    Little Rock, Arkansas

    • Co-Author(s)

  • HT

    Huy Tran, DO

    Resident PGY-3
    University of Arkansas for Medical Sciences PM&R Program
    Little Rock, Arkansas

  • Nam Vo, DO

    Chief Resident Physician, PGY-4
    University of Arkansas for Medical Sciences PM&R Program
    Little Rock, Arkansas

  • JT

    John R. Tait, MD

    Attending and staff physician
    Little Rock VA
    Little Rock, Arkansas

Disclosure(s):
Courtney L. Chamberlin, DO: No financial relationships to disclose
Nam Vo, DO: No financial relationships to disclose
Case Diagnosis: Acute carpal tunnel syndrome secondary to Pasteurella multocida infection.

Case Description or Program Description: The patient presented with three days of right hand pain and swelling after a cat bite to his right index finger. Right upper extremity CT scan was suspicious for cellulitis and flexor tenosynovitis with possible carpal tunnel involvement. He was treated empirically with IV Vancomycin and Unasyn. Right hand incision and drainage (I&D) and carpal tunnel release were performed and fluid culture revealed Pasteurella multocida. Four months after surgery, symptoms persisted with new onset tingling to the right index and long fingers, and he was referred for a nerve conduction study and electromyography (NCS/EMG).

Setting: Veterans Affairs (VA) NCS/EMG clinic

Assessment/Results: The patient had limited finger flexion range of motion in digits 1-5, decreased sensation of distal digits 2-3, and positive Tinel’s at the right wrist. NCS showed reduced amplitude (4.3 mV) of the right ulnar motor nerve. The left ulnar sensory nerve had prolonged distal peak latency (4.7 mls) and decreased conduction velocity (30 m/s). Left versus right side comparison data for the media motor nerve indicates abnormal conduction velocity (16 m/s difference) and median sensory nerve with abnormal left-right amplitude difference (-77%). EMG study of right upper extremity was unremarkable.

Discussion (relevance): Soft tissue infections with Pasteurella multocida usually occur after cat bites, cat scratches, or dog bites and characteristically have a rapid development of an intense inflammatory response. In this case, compression from the edema may have caused axonal and demyelinating injuries, with the myelin having recovered sooner than axonal recovery.

Conclusions: This case highlighted the development of acute carpal tunnel syndrome secondary to Pasteurella multocida cellulitis. Physicians should be aware of this uncommon potential peripheral nerve injury when working up a cat bite wound.