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Acute pasteurella multocida in total knee arthroplasty
James B Stiehl1, Lawrence A Sterkin, Charles F Brummitt
1Midwest Orthopaecis Biomechanical Laboratory, Columbia Hospital, Milwaukee, Wisconsin, USA.
Abstract:
Pasturella multocida is a rare cause of joint sepsis in total joint arthroplasty, and all case reports have identified a distant source of infection from an animal bite that has caused potential hematogenous seeding of the prosthesis. We report a case in which no potential distal wound source was found and the only likely etiology was local wound seeding from an old injury. In that injury, a saddle stirrup had caused a severe traumatic soft tissue injury as a horse had rolled over the patient. We draw attention to the fact that this particular bacteria is virulent in producing septic contamination of a total joint prosthesis, and aggressive treatment is indicated when such infection is identified.
Insights
Pasteurella multocida is a rare cause of joint sepsis in total joint replacements. This case highlights local wound seeding from an old injury, not a distant animal bite, as a potential cause.
Area of Science:
- Orthopedic surgery
- Infectious disease
Background:
- Joint sepsis in total joint arthroplasty is uncommon.
- Pasteurella multocida is a rare pathogen in these infections, typically linked to animal bites.
Observation:
- A case of Pasteurella multocida joint sepsis following total knee arthroplasty is presented.
- The patient had a history of a severe soft tissue injury from a horse-related incident, but no recent animal bite was identified.
Findings:
- The infection was likely due to local wound seeding from the old traumatic injury, rather than hematogenous spread from a distant source.
- Pasteurella multocida demonstrated high virulence in contaminating the prosthetic joint.
Implications:
- This case expands the understanding of Pasteurella multocida joint sepsis etiology in total joint arthroplasty.
- Aggressive treatment is crucial for managing Pasteurella multocida prosthetic joint infections.