Abstract
Introduction: We present a rare case of wound and vascular graft infection caused by Haemophilus parainfluenzae after reconstruction of the femoral artery bifurcation. Case presentation: H. parainfluenzae was isolated from pus samples taken from a patient who had undergone angioplasty of the superficial femoral artery and anastomosis with a synthetic graft. The pathogen was isolated from samples taken from both the wound and the graft. Management involved wide surgical debridement and irrigation, preservation of the prosthetic graft and transposition of muscle flaps in conjunction with the administration of culture-based antimicrobials. Conclusion: H. parainfluenzae surgical wound and vascular graft infections are uncommon, and quick diagnosis and preservation of the graft is of great importance in treatment.
Highlights
We present a rare case of wound and vascular graft infection caused by Haemophilus parainfluenzae after reconstruction of the femoral artery bifurcation
H. parainfluenzae has been reported as the causative agent of systemic infections such as endocarditis (Darras-Joly et al, 1997; Winn et al, 2005) and less commonly of bacteraemia, pneumonia, empyema, epiglottitis, meningitis, arthritis, cerebral abscess, urethritis and genital infections (Oill et al, 1979; Chu & Sexton, 2008; Winn et al, 2005)
We describe a wound and subsequent vascular graft infection by H. parainfluenzae
Summary
Haemophilus parainfluenzae is an unusual pathogen in human infections. H. parainfluenzae has been reported as the causative agent of systemic infections such as endocarditis (Darras-Joly et al, 1997; Winn et al, 2005) and less commonly of bacteraemia, pneumonia, empyema, epiglottitis, meningitis, arthritis, cerebral abscess, urethritis and genital infections (Oill et al, 1979; Chu & Sexton, 2008; Winn et al, 2005). As there was no improvement in the clinical picture, a second culture of the purulent exudate was obtained, which confirmed the presence of S. epidermidis, which was methicillin resistant. This organism showed resistance to fucidic acid, macrolides, quinolones and rifampicin. Along with S. epidermidis, Escherichia coli was isolated, which was resistant to ampicillin, piperacillin, tetracycline, quinolones and aminoglycosides These bacteria are members of the skin flora, intravenous linezolid (600 mg twice daily) in combination with ceftriaxone (2 g once daily) were administered according to the susceptibility results of the pathogens (linezolid MIC for S. epidermidis of 1 mg ml and ceftriaxone MIC for E. coli of 1 mg ml21), in order to prevent any contamination of the graft itself, and all previously administered antimicrobials were discontinued. She returned 6 days later with complete healing of the trauma, in good condition and free of any symptoms, and the cutaneous sutures were cut
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