Mohan Priya, Diaz Ashley R, Lee Siwon
American University of the Caribbean, School of Medicine, 1 University Dr, Jordan Road, Cupecoy, Sint Maarten.
Mayo Clinic, College of Medicine and Science, 200 1st St SW, Rochester, MN 55905, USA.
IDCases. 2023 Feb 17;31:e01723. doi: 10.1016/j.idcr.2023.e01723. eCollection 2023.
, is a bacterium that is frequently transmitted to humans from domestic pets. Infections are generally localized, but previous reports have exhibited that Pasteurella can cause systemic infections such as peritonitis, bacteremia and in some rare cases tubo-ovarian abscess.
We present a case of a 46-year-old woman who came to the emergency department (ED) with complaints of pelvic pain, abnormal uterine bleeding (AUB), and fever. A non-contrast computed tomography (CT) of abdomen and pelvis showed uterine fibroids with sclerotic changes in lumbar vertebrae and pelvic bones causing a high degree of suspicion for cancer. On admission, blood culture, complete blood count (CBC) and tumor markers were drawn. Additionally, an endometrial biopsy was performed to rule out the possibility of endometrial cancer (EC). The patient underwent an exploratory laparoscopy with hysterectomy and bilateral salpingectomy. After diagnosis with P. the patient was treated with five days of Meropenem.
There are few cases of peritonitis reported; in addition, findings of AUB with sclerotic bony changes in a middle-aged woman is often associated with EC. Thus, clinical suspicion from patient history, infectious disease work-up and diagnostic laparoscopy are essential for proper diagnosis and management.
巴斯德氏菌是一种经常从家养宠物传播给人类的细菌。感染通常为局部性的，但先前的报告显示，巴斯德氏菌可引起全身感染，如腹膜炎、菌血症，在一些罕见情况下还可引起输卵管卵巢脓肿。
我们报告一例46岁女性病例，该患者因盆腔疼痛、异常子宫出血（AUB）和发热前来急诊科就诊。腹部和盆腔的非增强计算机断层扫描（CT）显示有子宫肌瘤，同时腰椎和骨盆骨有硬化改变，这引起了对癌症的高度怀疑。入院时，进行了血培养、全血细胞计数（CBC）和肿瘤标志物检查。此外，还进行了子宫内膜活检以排除子宫内膜癌（EC）的可能性。患者接受了 exploratory laparoscopy（此处原文似乎有误，可能是“exploratory laparotomy”，即剖腹探查术），同时进行了子宫切除术和双侧输卵管切除术。在诊断为巴斯德氏菌感染后，患者接受了为期五天的美罗培南治疗。
报道的巴斯德氏菌腹膜炎病例很少；此外，中年女性出现AUB并伴有骨质硬化改变的情况通常与EC有关。因此，根据患者病史进行临床怀疑、传染病检查和诊断性腹腔镜检查对于正确的诊断和管理至关重要。
