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Pasteurella multocida infection in total knee arthroplasty. Case report and literature review
1Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY 10021.
Abstract:
Pasteurella multocida, a small gram-negative bacterium, is part of the normal mouth flora of many animals, including domestic cats and dogs. While commonly associated with infections in animals, it is a rare cause of human disease. The majority of Pasteurella infections in humans occur with percutaneous inoculation of the organism following a bite by a cat or dog, although disease without antecedent animal exposure or with causal animal contact does occur. The spectrum of disease produced ranges from localized, including abscess, cellulitis, lymphadenopathy, and osteomyelitis, to systemic, with septicemia, septic arthritis, respiratory, and central nervous system involvement. Altered host defenses and underlying chronic disease, such as rheumatoid arthritis, corticosteroid therapy, and severe hepatic or renal disease, may predispose to more serious systemic manifestations of infection. The authors report a case of P. multocida infection in a total knee arthroplasty as a result of a dog scratch and review the literature reporting P. multocida infections in total knee arthroplasty.
Insights
Pasteurella multocida, a bacterium common in animal mouths, rarely causes human illness. This case highlights its potential to infect prosthetic joints, like total knee arthroplasty, following animal scratches.
Area of Science:
- Infectious Diseases
- Microbiology
- Orthopedic Surgery
Background:
- Pasteurella multocida is a Gram-negative bacterium typically found in the oral microbiota of domestic animals.
- While usually causing animal infections, it can cause human disease, primarily through animal bites.
- Human infections range from localized conditions to severe systemic diseases.
Observation:
- A case of Pasteurella multocida infection in a total knee arthroplasty (TKA) is presented.
- The infection was linked to a dog scratch, demonstrating a non-bite inoculation route.
- The patient had a prosthetic joint, a potential site for opportunistic infections.
Findings:
- Pasteurella multocida can cause deep-seated infections in prosthetic joints.
- Infection occurred despite the absence of a bite, via percutaneous inoculation from a scratch.
- Review of literature indicates P. multocida is an uncommon but potential pathogen in TKA infections.
Implications:
- Clinicians should consider Pasteurella multocida in cases of prosthetic joint infections, even with non-bite animal contact.
- Prompt diagnosis and appropriate antibiotic therapy are crucial for managing P. multocida prosthetic joint infections.
- This case broadens the understanding of Pasteurella multocida transmission and infection risks in orthopedic surgery patients.