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Venoarterial extracorporeal membrane oxygenation for septic cardiomyopathy caused by Pasteurella multocida infection: a case report.
Journal of Anesthesia 2022 June
Pasteurella is a gram-negative coccobacillus that is commonly transmitted through cat and dog bites and causes various diseases in humans. In the present case, kissing an animal caused Pasteurella multocida infection, leading to sepsis and cardiogenic shock. We used venoarterial extracorporeal membrane oxygenation (VA-ECMO) to support the cardiovascular system until recovery. A 62-year-old man with no relevant history was referred to our hospital with a 1-day history of sore throat and fever. He was diagnosed with cervical cellulitis and later developed septic shock, which necessitated catecholamine administration and intubation. It was subsequently revealed that the patient had Pasteurella multocida bacteremia and kept a pet dog at home. In addition to sepsis, the patient experienced refractory cardiogenic shock and was unresponsive to medical treatment; therefore, VA-ECMO was initiated. After its introduction, the patient's hemodynamic status improved, and he was weaned from extracorporeal circulation after 6 days. He was discharged home and resumed his former life 50 days later. Pasteurella multocida infection can cause sepsis followed by severe cardiac dysfunction in healthy adults. Therefore, VA-ECMO may be a useful treatment option in patients with sepsis-induced myocardial dysfunction and refractory cardiogenic shock.
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