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感染性主动脉瘤合并多杀巴斯德菌感染 1 例:临床病理表现及文献复习

An autopsy case of infective aortic aneurysm with Pasteurella multocida infection: clinicopathological appearance and a review of literatures.

机构信息

Department of Pathology, Koseiren Takaoka Hospital, 5-10 Eiraku-cho, Takaoka, Toyama, 933-8555, Japan.

Department of Legal Medicine, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan.

出版信息

Ann Clin Microbiol Antimicrob. 2023 Jul 11;22(1):58. doi: 10.1186/s12941-023-00611-0.

Abstract

Here, we showed our clinicopathological findings of infected aortic aneurysm (IAA) with Pasteurella multocida, which is a Gram-negative coccobacillus and is part of the normal oral flora of many animals. The patient was a 76-year-old male animal owner with a history of diabetes mellitus, alcoholic liver damage, and laryngeal cancer. He died 16 days after admission without undergoing operation because of poor general condition. Autopsy showed saccular outpouching with loss of the existing aortic wall and marked neutrophilic infiltration in the suprarenal abdominal aorta. Rupture was not evident. A polymerase chain reaction assay using DNA extracted from formalin-fixed paraffin-embedded specimen of the aneurysmal wall detected the Pasteurella multocida gene, therefore we conclude that the present case was IAA of native aorta with Pasteurella multocida infection. A review of the literature showed that IAA of native aorta with Pasteurella multocida infection is opportunistic and that liver disorder, alcohol addiction, diabetes mellitus, and animal bite may increase its risk. On the other hand, aortic endograft infection with Pasteurella multocida frequently occurred without an immunocompromised state. Pasteurella multocida may be a distinct causative microorganism in IAA, and/or sepsis when the participant is an animal owner.

摘要

在这里,我们展示了一例由多杀巴斯德菌(Pasteurella multocida)引起的感染性主动脉瘤(IAA)的临床病理发现,多杀巴斯德菌是一种革兰氏阴性球杆菌,是许多动物口腔正常菌群的一部分。患者为 76 岁男性,有糖尿病、酒精性肝损伤和喉癌病史。由于一般状况不佳,他在入院后 16 天死亡,未接受手术。尸检显示囊状膨出,失去了现有的主动脉壁,肾上腺腹主动脉有明显的中性粒细胞浸润。没有明显的破裂。使用从动脉瘤壁福尔马林固定石蜡包埋标本中提取的 DNA 进行聚合酶链反应检测到多杀巴斯德菌基因,因此我们得出结论,本例为原发性主动脉的感染性主动脉瘤。文献回顾表明,多杀巴斯德菌引起的原发性主动脉感染性主动脉瘤是机会性的,肝疾病、酗酒、糖尿病和动物咬伤可能会增加其风险。另一方面,带有人工移植物的主动脉感染性主动脉瘤常发生于无免疫抑制状态。当参与者是动物主人时,多杀巴斯德菌可能是 IAA 和/或败血症的一种独特的致病微生物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f17/10334504/0b27c6521b08/12941_2023_611_Fig1_HTML.jpg

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