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    A bite difficult to heal: induced decompensated hepatic cirrhosis

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    Author
    Patel, Hiren
    Patel, Nirali
    Patel, Harsh
    Chow, Robert Dobbin
    Date
    2021-05-10
    Journal
    Journal of Community Hospital Internal Medicine Perspectives
    Publisher
    Taylor and Francis Inc.
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1080/20009666.2021.1906490
    Abstract
    Pasteurella multocida is a gram-negative bacterium that colonizes domestic animals. It is commonly implicated in bite and scratch wounds, potentially resulting in cellulitis, superficial abscesses, osteomyelitis, or peritonitis. Rarely, it can lead to bacteremia and septic shock in high-risk patients. We present an atypical presentation of Pasteurella multocida bacteremia and sepsis in a patient with stage 4 decompensated cirrhosis. The patient presented with melena and altered mental status with CT imaging showing a heterogeneous nodular liver along with an enlarged portal vein, gastric varices, and ascites consistent with decompensated cirrhosis. The patient was initially managed with intravenous (IV) octreotide and pantoprazole, blood and platelet transfusions, and broad-spectrum antibiotics. Upper endoscopy showed diffuse non-bleeding esophageal and gastric varices, which required band ligation and continued IV octreotide therapy. The infection resolved after a 7-day course of IV ceftriaxone.
    Rights/Terms
    © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center.
    Keyword
    Pasteurella multocida
    bacteremia
    cellulitis
    decompensated cirrhosis
    immunosuppressed
    sepsis
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/16161
    ae974a485f413a2113503eed53cd6c53
    10.1080/20009666.2021.1906490
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