Pasteurella multocida-infected expanded polytetrafluoroethylene hemodialysis access graft

Area of Science:

• Infectious Diseases
• Vascular Surgery
• Nephrology

Background:

• Prosthetic hemodialysis access grafts are essential for patients with end-stage renal disease.
• Graft infections represent a significant complication, potentially leading to graft failure and systemic infection.
• While common pathogens are frequently implicated, rare causative agents require careful consideration.

Observation:

• A case of a nonfunctioning expanded polytetrafluoroethylene (ePTFE) graft in the forearm is presented.
• The patient had a history of a cat bite preceding the graft dysfunction.
• Surgical exploration revealed a completely unincorporated graft.

Findings:

• Operative cultures confirmed infection with Pasteurella multocida, a bacterium typically found in the oral flora of domestic animals like cats and dogs.
• This represents the first reported instance of a dialysis access graft infection caused by P. multocida.
• The P. multocida infection led to graft nonfunction and necessitated complete graft excision.

Implications:

• This case expands the spectrum of pathogens associated with prosthetic graft infections.
• It underscores the importance of considering animal-related injuries, such as cat bites, as a potential source of unusual graft infections.
• Prompt diagnosis and appropriate antibiotic therapy, such as intravenous ceftriaxone, are crucial for successful management and wound healing.