Abstract
A 28-year-old male patient undergoing hemodialysis was admitted to our hospital due to severe pain and swelling of the left forearm. An aneurysm of the arteriovenous shunt located in the left forearm had been bitten by a cat earlier the same day. We diagnosed as phlegmon cellulitis around the aneurysm. Blood flow in the arteriovenous shunt had already stopped on arrival. Although amikacin, piperacillin and clindamycin were immediately administered, the inflammatory reaction increased and high fever persisted. Since Pasteurella multocida was isolated from the wound discharge, we changed the antibiotics to panipenem/betamipron and minocycline. Although inflammation improved, the aneurysm suddenly ruptured on the 22 hospital day. We urgently performed aneurysmectomy. The wall of the aneurysm was weakened probably due to the infection.
The incidence of Pasteurella multocida infection after cat bite has recently increased. This case is the first report of vascular access infection by Pasteurella multocida.
