Successful Management of Pasteurella multocida Pneumonia in a Chronic Obstructive Pulmonary Disease Patient: A Case Report Highlighting the Importance of Tailored Antibiotic Therapy.

This report describes a patient with Pasteurella multocida pneumonia. The patient was a man in his 70s with significant comorbid conditions, including chronic obstructive pulmonary disease (COPD), and is an example of the diverse presentations of P. multocida infections increasingly found in the literature. The novelty of this case lies in the manifestation of P. multocida pneumonia in a patient with underlying respiratory conditions and its successful management, outlining a unique clinical scenario and a tailored therapeutic approach. A 71-year-old male with a medical history of COPD, asthma, tremors, hypertension, and arthritis presented to the emergency department with progressive shortness of breath, productive cough, and chest tightness. The initial diagnosis was COPD exacerbation and left lower lobe pneumonia, for which a regimen of ceftriaxone and azithromycin was initiated. The patient's condition was further complicated by the persistence of symptoms. Following sputum culture analysis, P. multocida infection was identified. Consequently, the antibiotic regimen was tailored, transitioning the patient to doxycycline, which led to substantial clinical improvement, enabling discharge with a 10-day course of oral doxycycline. This case elucidates the importance of precise microbiological diagnosis in patients with complex respiratory conditions, as it guides more targeted antibiotic therapy. It highlights the need for clinical vigilance for atypical pathogens like P. multocida in patients with COPD exacerbations, especially when conventional treatment strategies yield suboptimal responses. The successful resolution of the pneumonia underscores the effectiveness of antibiotic stewardship guided by sputum culture findings.

Unique Acute Phytophotodermatitis Reaction and a Visual Diagnostic Guide.

Here, we describe a case of a 48-year-old caucasian female with no significant past medical history who presented to the outpatient dermatology clinic with an extremely painful and significant phytophotodermatitis (PPD) reaction to over 30% of her body surface area. The patient presented after partaking in a ritualistic ceremony where she was exposed to plant and citrus juices and subsequently sunbathed while on a tropical vacation. While not an infrequent diagnosis, this patient presented to the dermatologist in extreme pain after having no education on avoiding such triggers. This diagnosis is relatively underdiagnosed and leads to a lack of patient counseling on the hazards of UV exposure secondary to contact with certain plant and fruit juices. Lack of patient awareness leads to an increase in disease burden. Furthermore, this patient suffered a large body surface area reaction in contrast to the pathognomonic description of phytophotodermatitis secondary to the exposure to lime juice which causes relatively less total body surface area exposure.