Deadly case ofPasteurella multocidaaortitis and mycotic aneurysm following a cat bite

Abstract

Animal bites are frequently encountered in the emergency department (ED). Aortitis leading to mycotic abdominal aortic aneurysm is a rare and potentially deadly complication of Pasteurella multocida (P. multocida) following an animal bite. We present the case of a 68-year-old male who presented to the ED after falling at home. He complained of weakness and abdominal pain. He was in septic shock and was treated empirically with broad-spectrum antibiotics and intravenous fluids. He reported previous antibiotic treatment of a cellulitis secondary to a cat bite injury to his right thumb four weeks prior. Abdominal ultrasound and subsequent computed tomography scan revealed a leaking mycotic abdominal aneurysm that was surgically repaired. Blood cultures and aortic wall tissue cultures grew P. multocida. Given how common animal bite presentations are in the ED, this case highlights the need to consider aortitis and mycotic abdominal aortic aneurysm in an unwell patient with an animal bite.

The Case of the Neighbour's Cat Causing a Symptomatic (Mycotic) Aortic Aneurysm and an Infected Endograft

“…Cho et al. 7 have also reported a case of mycotic aneurysm caused by P. multocida infection following a cat bite. In this report, the patient presented with a symptomatic (mycotic) aneurysm because of exposure to P. multocida that was not identified at the point of endovascular intervention.…”

“… 5 , 6 There are case reports of patients who have developed aortitis and mycotic aneurysms as a result of P. multocida infection. 7 Here an interesting clinical presentation of an infected EVAR graft is reported. The endovascular intervention was performed to treat an acutely symptomatic abdominal aortic aneurysm (AAA) that was retrospectively diagnosed as a mycotic AAA resulting from P. multocida infection from a cat bite.…”

Pasteurella Cerebral Mycotic Aneurysm: A Case Report and Review of the Literature

“…Pasteurella spp. have been described as a cause of mycotic aneurysms in only nine previous cases (Table 2) [7][8][9][10][11][12][13][14][15], one of which involved a cerebral mycotic aneurysm [7]. This was reported in a 17-year-old male with amoxicillin-treated mitral valve endocarditis, whose mycotic aneurysm was not recognized until autopsy.…”

Pseudoaneurysm formation after Pasteurella multocida lower extremity vascular bypass graft infection

“…It has been implicated as the causative agent in a broad spectrum of clinical presentations, including infection after solid organ transplantation,8, 9 bacteremia and septic shock,10, 11, 12 and cellulitis and lymphangitis 13, 14. Within the realm of vascular surgery, P. multocida has been implicated as the cause of aortitis and mycotic aortic aneurysm,15, 16, 17 infected aortic endografts,18, 19, 20, 21, 22, 23 hemodialysis access grafts, 24 and peripheral vascular bypass grafts25, 26 in several case reports. The Table shows selected similar published cases and their outcomes.…”