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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Trauma+Case+Rep
2018 ; 13
(ä): 18-21
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English Wikipedia
Serious phlegmonous lesion of the hand following an injury by vegetal thorn:
Never forget Pasteurella multocida!
#MMPMID29644292
Maleb A
; Elmalki J
; Bouayadi O
; Ben Lahlou Y
; Frikh M
; Abdeljaouad N
; Lemnouer A
; Yacoubi H
; Elouennass M
Trauma Case Rep
2018[Feb]; 13
(ä): 18-21
PMID29644292
show ga
Pasteurella multocida can cause serious infections after dog or cat bite. We
report here a rare case of hand infection caused by P. multocida consecutive to
an injury by a thorn of the prickly pear. It caused an amputation of the distal
phalanx of the thumb in a trisomic patient. It is about a 27-year-old man who was
admitted to the hospital with swelling and intense pain of the left hand. He
reported a sting by a thorn of prickly pear 15 days before. The patient was
admitted to proceed with operative irrigation and debridement. The pus was
collected for microbiological examination. Microscopic examination after Gram
staining revealed small Gram-negative coccobacilli, associated to
polymorphonuclear reaction. Culture have objectivated Pasteurella multocida. The
isolated strain was susceptible to betalactamins. Patient was treated with
ampicillin. Well-conducted antibiotics and repetitive local cares have not
prevented local lesions from progressing to necrosis of the soft parts of the
thumb and osteitis of the distal phalanx of the thumb. The patient underwent a
necrosectomy and an amputation of the distal phalanx. Ampicillin was replaced by
amoxicillin/clavulanic acid and after 15 days, progression was clinically and
microbiologically favorable. In the case we report, since the patient does not
report any exposure or contact with animals, the thorn prick is the source of
infection. It was contaminated from the animal reservoir. Taking into account the
monomicrobism of the infection, treatment with aminopenicillins was sufficient.
Our propositus came to the hospital 15 days after the inoculation of the
bacterium. This duration appears to be very late in relation to the acute
character of pasteurellosis. This was probably the main reason why the local
infection evolved towards osteoarticular complications. That's why, we should
consider Pasteurella multocida in case of infection by inoculation, even in the
absence of contact with the animals.