Published online Jun 16, 2016. doi: 10.12998/wjcc.v4.i6.142
Peer-review started: February 2, 2016
First decision: March 25, 2016
Revised: April 6, 2016
Accepted: April 21, 2016
Article in press: April 23, 2016
Published online: June 16, 2016
Animal bites are frequently encountered in the emergency department (ED). Aortitis leading to mycotic abdominal aortic aneurysm is a rare and potentially deadly complication of Pasteurella multocida (P. multocida) following an animal bite. We present the case of a 68-year-old male who presented to the ED after falling at home. He complained of weakness and abdominal pain. He was in septic shock and was treated empirically with broad-spectrum antibiotics and intravenous fluids. He reported previous antibiotic treatment of a cellulitis secondary to a cat bite injury to his right thumb four weeks prior. Abdominal ultrasound and subsequent computed tomography scan revealed a leaking mycotic abdominal aneurysm that was surgically repaired. Blood cultures and aortic wall tissue cultures grew P. multocida. Given how common animal bite presentations are in the ED, this case highlights the need to consider aortitis and mycotic abdominal aortic aneurysm in an unwell patient with an animal bite.
Core tip: Mammalian bites are common and represent a large number of emergency department visits. Emergency physicians are well versed in identifying and treating early cellulitic complications of animal bites. The delayed sequelae of cat bites, aortitis and mycotic abdominal aneurysm, are important to consider when assessing sick patients with a recent bite injury. Early recognition of this pathology could expedite optimal care for these patients.