Femoral artery aneurysm with large hematoma from Pasteurella: case report and literature review

Abstract

Background Pasteurella multocida is a well-known gram-negative facultative anaerobe well known for its ability to cause soft tissue infections following animal bite or scratch. Here we present a case with mycotic aneurysm of the superficial femoral artery due to P. multocida infection. Case presentation A 62 year old male patient presented with worsening right leg pain and swelling. On examination, he was found to have profound swelling and erythema of the right medial thigh and tenderness to palpation. Computerized tomography showed findings suggestive of right femoral pseudoaneurysm with a large right medial thigh hematoma. Blood cultures grew P. multocida. Patient underwent emergent open resection of the mycotic aneurysm and vascular bypass surgery. Intraoperatively, the site was noted to be grossly infected with multiple pockets of pus which were drained and pus cultures grew P. multocida. The diagnosis of P. multocida bacteremia with right femoral mycotic aneurysm and thigh abscess was made. Patient received 6 weeks of intravenous ceftriaxone and recovered. Conclusion Our case is the first report on infection of peripheral vessel with Pasteurella and highlights the importance of prompt surgical intervention and effective antibiotic treatment

Bloodstream infection, peritonitis, and pneumonia caused by Pasteurella multocida in a patient with liver cirrhosis despite no animal contact: case report and literature review

“…Fortunately, with effective antimicrobial treatment, the pulmonary infiltrates and pleural effusion resolved, suggesting that the primary concern was pneumonia and pleural effusion caused by P. multocida infection. The drug sensitivity testing of P. multocida in this case revealed sensitivity to penicillin, cephalosporins, quinolones, and other commonly used antibiotics, which is consistent with previous case reports ( Rondon-Berrios and Trevejo-Nunez, 2010 ; Abdelkarim et al., 2014 ; Katechakis et al., 2019 ; Hanson et al., 2022 ). Upon admission, ceftriaxone was chosen as the empirical antimicrobial treatment, and subsequent drug sensitivity testing confirmed its effectiveness.…”

Pasteurella Multocida Infection in Humans

“…P. multocida bacteremia causing aortic valve dysfunction with endocarditis [54][55][56], myopericarditis following a dog bite [57], pericardial tamponade after a cat bite [58], and endocarditis in a patient with intravenous drug abuse were described [59]. Single cases of femoral artery aneurysm with large hematoma caused by P. multocida [60] and infection resulting in a descending thoracic aorta mycotic pseudoaneurysm were described [61]. Positive blood culture results were obtained in each reported case, and direct contact with a domestic animal was confirmed.…”