Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2016; 4(6): 142-145
Published online Jun 16, 2016. doi: 10.12998/wjcc.v4.i6.142
Deadly case of Pasteurella multocida aortitis and mycotic aneurysm following a cat bite
Dennis Dane Cho, Yaniv Berliner, David Carr
Dennis Dane Cho, Yaniv Berliner, David Carr, Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, ON M4N 3M5, Canada
Dennis Dane Cho, Yaniv Berliner, David Carr, Department of Emergency Medicine, University Health Network, Toronto, ON M5G 2C4, Canada
Author contributions: All authors have made substantive contributions to this case report; Cho DD and Berliner Y were responsible for manuscript preparation; all authors participated in critical revision of the manuscript.
Institutional review board statement: Institutional review board approval was not obtained due to the nature of the paper.
Informed consent statement: Waiver of informed consent for human study subjects is justifiable given the anonymous nature of the case and how no patient identifiers are used in the case particulars. As such, explicit consent to publish the case was not obtained.
Conflict-of-interest statement: The authors report no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dennis Dane Cho, MD, Emergency Medicine Resident, Department of Emergency Medicine, University Health Network, R. Fraser Elliott Bldg., Ground - 480, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada.
Telephone: +1-416-3403856 Fax: +1-416-4806797
Received: January 30, 2016
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.

Keywords: Mycotic aneurysm, Emergency department, Cat bite, Pasteurella multocida, Aortitis

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.