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Pasteurella multocida tenosynovitis of the hand: sonographic findings
Montserrat García Triana1, María Antonia Fernández Echevarria, Rosa Landeras Alvaro
1Department of Radiology, Marqués de Valdecilla University Hospital, Avenida Valdecilla, s/n, 39008 Santander, Cantabria, Spain.
Abstract:
Pasteurella multocida is a common cause of infection in humans subsequent to bites or scratches by dogs and, particularly, cats. This infection usually results in superficial skin and soft tissue infections. Sonography can be used for diagnosing inflammatory conditions affecting tendons, including acute and chronic tenosynovitis. P. multocida tenosynovitis is rare, and the diagnosis can be missed if adequate tests are not performed. We report 2 cases of P. multocida tenosynovitis of the hand and wrist in which sonography played a valuable role in assessing the affected tissues and guiding fine-needle aspiration of fluid accumulations in the involved tendon sheaths. The diagnosis was confirmed microbiologically in each case.
Insights
Pasteurella multocida can cause rare tenosynovitis, an infection of the tendon sheath, often missed in diagnoses. Sonography aids in identifying this infection following animal bites, guiding treatment for hand and wrist cases.
Area of Science:
- Medical Microbiology
- Diagnostic Imaging
- Musculoskeletal Diseases
Background:
- Pasteurella multocida is a common zoonotic pathogen, typically causing superficial infections after animal bites.
- Tenosynovitis, inflammation of the tendon sheath, can be caused by various pathogens.
- Early and accurate diagnosis of tenosynovitis is crucial for effective management and preventing complications.
Observation:
- Two cases of Pasteurella multocida tenosynovitis affecting the hand and wrist are presented.
- Sonography was utilized to visualize inflammatory changes and fluid collections within the tendon sheaths.
- Fine-needle aspiration was guided by sonographic findings for microbiological confirmation.
Findings:
- Sonography effectively assessed soft tissue inflammation and guided aspiration in P. multocida tenosynovitis.
- Microbiological confirmation identified Pasteurella multocida as the causative agent in both cases.
- The diagnosis of P. multocida tenosynovitis was confirmed in these rare instances.
Implications:
- Sonography is a valuable tool for diagnosing rare P. multocida tenosynovitis, especially in the hand and wrist.
- Increased awareness of P. multocida tenosynovitis can improve diagnostic rates and patient outcomes.
- This imaging modality aids in targeted microbiological sampling for definitive diagnosis and treatment planning.