Guion T L, Sculco T P
Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY 10021.
J Arthroplasty. 1992 Jun;7(2):157-60. doi: 10.1016/0883-5403(92)90009-f.
Pasteurella multocida, a small gram-negative bacterium, is part of the normal mouth flora of many animals, including domestic cats and dogs. While commonly associated with infections in animals, it is a rare cause of human disease. The majority of Pasteurella infections in humans occur with percutaneous inoculation of the organism following a bite by a cat or dog, although disease without antecedent animal exposure or with causal animal contact does occur. The spectrum of disease produced ranges from localized, including abscess, cellulitis, lymphadenopathy, and osteomyelitis, to systemic, with septicemia, septic arthritis, respiratory, and central nervous system involvement. Altered host defenses and underlying chronic disease, such as rheumatoid arthritis, corticosteroid therapy, and severe hepatic or renal disease, may predispose to more serious systemic manifestations of infection. The authors report a case of P. multocida infection in a total knee arthroplasty as a result of a dog scratch and review the literature reporting P. multocida infections in total knee arthroplasty.
多杀巴斯德菌是一种革兰氏阴性小杆菌，是包括家猫和家犬在内的许多动物口腔正常菌群的一部分。虽然它通常与动物感染有关，但却是人类疾病的罕见病因。人类的大多数多杀巴斯德菌感染是在被猫或狗咬伤后经皮接种该病原体所致，不过也确实存在无先前动物接触史或无相关动物接触而发病的情况。所产生的疾病谱范围从局部性疾病，包括脓肿、蜂窝织炎、淋巴结病和骨髓炎，到全身性疾病，伴有败血症、化脓性关节炎、呼吸系统和中枢神经系统受累。宿主防御功能改变和潜在的慢性疾病，如类风湿性关节炎、皮质类固醇治疗以及严重的肝脏或肾脏疾病，可能易导致更严重的全身性感染表现。作者报告了一例因狗抓伤导致全膝关节置换术后发生多杀巴斯德菌感染的病例，并回顾了报告全膝关节置换术后多杀巴斯德菌感染的文献。
