Pınar KORKMAZ, Yeşim ALPAY, Nevil AYKIN, Figen ÇEVİK

Kedi tırmalaması sonrası Pasteurella multocida'ya bağlı abse: Olgu sunumu

Sağlıklı kedilerin %50 ile %70'inde Pasteurella multocida izole edilmekte ve hayvanın tırmalaması ya da ısırmasını takiben gelişen deri ve yumuşak doku infeksiyonlarına sıklıkla neden olabilmektedir. Yaralanmanın olduğu bölge ve derinliği itibariyle derin doku infeksiyonları, septik artrit, osteomyelit gibi çok daha ciddi infeksiyonlara yol açabilmektedir. Buna rağmen hangi yaranın infekte olacağını gösteren prediktif faktör yoktur. Bizim olgumuz kedi tırmalaması sonrası oluşan abse nedeniyle başvurdu ve etken olarak P. multocida saptandı. Bu durum, ''ilk başvuruda immünoprofilaksiye (temas sonrası kuduz ve tetanoz profilaksisi) ilaveten antibiyoprofilaksi hangi vakalara uygulanmalı?'' sorusunu bir kez daha gözden geçirmemize neden oldu. Seçilmiş vakalarda; orta ve şiddetli ezilme şeklinde yaralanmalarda özellikle ödematöz formda, yaralanmanın üzerinden sekiz saatten az bir zaman geçmişse, kemik veya eklem penetrasyonu ihtimali varsa, el yaralanmalarında, 3-5 gün süre ile antibiyoterapi önerilmekte ve özellikle el yaralanmaları ve derin penetrasyonlarda antibiyoterapinin önemi vurgulanmaktadır.

An abscess due to Pasteurella multocida after a cat scratch: Case report and evaluation of antibiotic prophylaxis

Pasteurella multocida has been isolated from 50% to 70% of healthy cats and most commonly associated with acute skin and soft tissue infections following an animal bite or scratch. Location and depth of injury can lead to more serious infections such as deep tissue infections, septic arthritis and osteomyelitis. However, no predictive factor showing which wound would be infected. In our case, patient whom applied with abscess after a cat scratch and P. multocida was found as a causative agent. This situation has caused to review us, once more, that which cases should be taken antibiotic prophylaxis in addition to immunoprophylaxis (for rabies post-exposure prophylaxis, and anti-tetanus prophylaxis) in the first admission. Antibiotic prophylaxis should be used for 3-5 days in selected cases if they include; moderate to severe crushing injuries especially edematous form, less than 8 hours old, bone or joint penetration, hand wounds, especially emphasizes the importance of hand injuries and deep penetrations. J Microbiol Infect Dis 2014; 4(4): 159-161

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