Infección aguda de prótesis total de rodilla tras mordedura y arañazo de gato: caso clínico y revisión de la bibliografía

Life-Threatening, Bleeding Pseudoaneurysm of the External Iliac Artery in the Setting of an Infected Total Hip Arthroplasty from Pasteurella multocida

We present a bleeding, infected (mycotic) pseudoaneurysm from the organism Pasteurella multocida. The patient presented septic from an infected total hip arthroplasty and was treated with surgical debridement, component retention, and antibiotics. She re-presented with hip pain and a marked hemoglobin decrease. Vascular studies revealed a pseudoaneurysm of the external iliac artery and large hematoma secondary to contiguous spread of her hip infection. The pseudoaneurysm was treated with an endovascular stent before further debridement surgery to avoid exsanguinating hemorrhage with surgical release of her tamponade. This case demonstrates the utmost importance of recognizing and treating vascular pathology in a patient with an infected prosthetic hip, large hematoma, and decreased hemoglobin.

Pasteurella multocida non-native joint infection after a dog lick: A case report describing a complicated two-stage revision and a comprehensive review of the literature

Pasteurella multocida is a Gram-negative coccobacillus that is part of the normal oral flora of animals, including domestic cats and dogs. Prosthetic joint infections due to P multocida typically occur following an animal lick or bite. The present review describes a two-stage revision arthroplasty associated with a P multocida joint infection caused by a dog lick. The authors also provide a comprehensive review of the literature surrounding P multocida prosthetic joint infections.

Prosthetic joint infections (PJIs) are commonly caused by pathogens such as Staphylococcus aureus and coagulase-negative staphylococci; however, other microbial etiologies and specific risk factors are increasingly recognized. Pasteurella multocida is a Gram-negative coccobacillus that is part of the normal oral flora in many animals, and is particularly common in dogs and cats. PJIs caused by P multocida have been reported only rarely in the literature and typically occur in the context of an animal bite or scratch. The present article describes a P multocida joint infection that occurred after a dog lick and complicated a two-stage revision arthroplasty. A comprehensive review of the literature regarding P multocida PJIs follows.

[Periprosthetic knee infection after a cat bite]

BACKGROUND

Infections caused by Pasteurella multocida are extremely rare in arthroplasty. We report the case of a patient who was bitten by his domestic cat, causing an infection of his knee arthroplasty.

DIAGNOSIS AND TREATMENT

The puncture of the knee resulted in putrid joint effusion. After removal of the knee prosthesis, infection with Pasteurella multocida was verified. We performed a two-stage revision combined with intravenous antibiotic therapy.

DISCUSSION

Infections caused by cats and dogs should attract more attention especially as prosthesis material represents a significant "locus minoris resistentiae". Patients with domestic pets should be informed about this source of infection and possible complications. In the case of a bite, prompt and liberal antibiotic treatment should be administered.

Prosthetic joint infection

Prosthetic joint infection (PJI) is a tremendous burden for individual patients as well as the global health care industry. While a small minority of joint arthroplasties will become infected, appropriate recognition and management are critical to preserve or restore adequate function and prevent excess morbidity. In this review, we describe the reported risk factors for and clinical manifestations of PJI. We discuss the pathogenesis of PJI and the numerous microorganisms that can cause this devastating infection. The recently proposed consensus definitions of PJI and approaches to accurate diagnosis are reviewed in detail. An overview of the treatment and prevention of this challenging condition is provided.