Bloodstream infection, peritonitis, and pneumonia caused by Pasteurella multocida in a patient with liver cirrhosis despite no animal contact: case report and literature review.

Pasteurella multocida is an opportunistic pathogen. Previously reported infections associated with P. multocida have often been linked to contact with cats, dogs, and other animals. Cases of systemic multiple-site infections following P. multocida infection are rare. This case study presents a 49-year-old middle-aged man with post-hepatitis B cirrhosis and no history of animal contact. The patient was admitted with symptoms of fever accompanied by diarrhea, abdominal distension, and cough. Blood tests showed elevated levels of CRP, PCT, and IL-6, and blood culture revealed the growth of P. multocida. CT scans revealed a large amount of abdominal effusion, a small amount of pleural effusion, and pulmonary infection foci. The patient's condition improved after successive administration of ceftriaxone and levofloxacin to fight the infection, and abdominal puncture and drainage. Multiple-site infections caused by P. multocida are rarely encountered in patients with liver cirrhosis but without animal contact, which could be regarded as serious conditions warranting careful attention in terms of clinical diagnosis and treatment.

[Pasteurella multocida Pneumonia with Hemoptysis in an Immunocompetent Case]. / Immün Kompetan Bir Olguda Hemoptizi ile Seyreden Pasteurella multocida Pnömonisi.

Pasteurella species are gram-negative bacilli found in healthy pets' oropharynx and gastrointestinal tract flora. In humans, skin and soft tissue infections develop most frequently with the bite or scratching of animals such as cats or dogs. At the same time, they cause infections in the respiratory tract, mainly in patients with chronic lung disease or immunosuppressive patients. In this case report, a rare case of pneumonia caused by P.multocida bacteria in a patient with bronchiectasis was presented. A young male patient was admitted to the emergency department of our hospital with complaints of hemoptysis, cough with phlegm, and weight loss. The patient's blood pressure was 140/82 mmHg and SO2= 94%. Rales and rhonchi were detected in the lower left lung during the examination. Standard thorax tomography revealed prominent cystic structures and pneumonic infiltrates in the left lower lobe. Laboratory findings were normal. The Coronavirus disease-2019 (COVID-19) quantitative real-time polymerase chain reaction (qRt-PCR) test was found to be negative in the nasopharyngeal swab sample taken from the patient. Fiberoptic bronchoscopy was performed on the patient to investigate the presence of endobronchial lesion or foreign body aspiration. Culture and cytological evaluation was requested from the bronchial lavage taken. Gram-negative coccobacilli were seen among dense polymorphonuclear leukocytes in the Gram stain of the sample. Acid-fast bacilli were not detected with Ehrlich Ziehl Neelsen stain. In the lavage culture evaluated after 24 hours, colonies growing in blood and chocolate media were stained and gramnegative coccobacilli were observed. The isolate was identified as 96.0% P.canis with the automated Vitek 2 (Biomerieux, France) system. It was determined that the isolate was susceptible to levofloxacin, trimethoprim-sulfamethoxazole, amoxicillin-clavulanic acid, penicillin, ciprofloxacin and cefotaxime in the antibiogram performed by disc diffusion test according to EUCAST v13.0 guideline criteria. Sequence analysis of the isolate obtained from the culture was performed on the ABI Prism 310 Genetic Analyzer (Applied Biosystems, USA). Sequence analysis of the isolate revealed 99.85% homology with P.multocida (GenBank accession no: NG_115137.1). Although Pasteurella multocida pneumonia is not commonly observed, the presence of underlying bronchiectasis in this patient facilitated the establishment of the bacteria. In order not to miss the diagnosis of pneumonia due to P.multocida, microbiological evaluation and molecular typing should be performed in the samples taken from the respiratory tract in patients with chronic respiratory diseases such as bronchiectasis.

Pediatric Pasteurella canis endophthalmitis.

We report an atypical presentation of endophthalmitis in a 2-month-old infant due to a rare infection by Pasteurella canis, small Gram-negative coccobacilli that inhabit the oral cavity and the gastrointestinal tracts of animals, including domesticated cats and dogs. Ocular infections are mainly associated with animal bites and scratches.

Pasteurella multocida as a Rare Cause of Neonatal Meningitis Complicated by Empyema.

A neonatal male injured by the family dog developed meningitis secondary to Pasteurella multocida . After initially defervescing with IV antibiotic treatment, he became febrile again, and imaging revealed a skull fracture and fluid collection. Following neurosurgical evacuation and an extended course of antibiotics, the patient was discharged home.

Treatment of Pasteurella multocida infection with dressings containing honey and antibacterials: a case report.

Infections secondary to Pasteurella multocida frequently occur in patients who have been exposed to domestic pets. Human infections caused by Pasteurella multocida vary in severity, and clinical features include localised cellulitis, osteomyelitis, systemic bacteraemia, meningitis and pneumonia. No vaccine has been developed against Pasteurella multocida; it is treated with antibacterial agents and, in most cases, surgical intervention. This article discusses the authors' experience in treating a woman with severe cellulitis and osteomyelitis on her hand caused by Pasteurella multocida. She refused surgical intervention and was successfully treated with honey-containing dressings and antibiotics after failure to heal following conservative treatment using conventional wound dressings combined with antibiotics.

Prognostic factors of Pasteurella infections: a single-center retrospective cohort study over a 14-year period (2005-2018).

BACKGROUND: Pasteurella spp. can lead to fatal infections in humans. OBJECTIVE: To assess prognostic factors of invasive pasteurellosis. METHODS: We conducted a single retrospective cohort study of local versus invasive Pasteurella infections from January 1, 2005, to December 31, 2018, in the Amiens-Picardie University Hospital, France. RESULTS: Forty-five (20.9%) invasive pasteurellosis and 22 (10.2%) complicated local infections were reported among a total of 215 Pasteurella infections. The mortality rate among invasive infections was 22.2% (10/ 45) whereas no death was recorded in local infections group. Non-drug-induced prothrombin time test <70% of standard and platelet counts <100,000/mm3 were more frequent in non-survivors than in survivors (p=0.005 and p=0.019) in univariate analyses. A history of neoplasia (adjusted OR=13.62, p=0.020), an evidence of bacteremia (adjusted OR=20.68, p=0.025), and hemoglobin level <10 g/dL (adjusted OR=17.80, p=0.028) were identified as poor prognostic factors in multivariate analyses. CONCLUSION: Invasive pasteurellosis appears as a serious disease in vulnerable patients, particularly if bacteremia and/or coagulopathies occur.

Pasteurella bacteraemia: Impact of comorbidities on outcome, based on a case series and literature review.

OBJECTIVES: Pasteurella bacteraemia is rare, but has been associated with a high mortality rate. The aim of this study was to estimate the impact of comorbidities on patients with Pasteurella bacteraemia. METHODS: All cases of Pasteurella bacteraemia in adults treated in our centre between January 2008 and December 2017 were included retrospectively and compared with cases identified in a systematic review of the literature via MEDLINE covering the years 1951-2017. The epidemiological, bacteriological, and clinical data were collected, as well as the instances of death after 30 days. RESULTS: Twenty cases of Pasteurella bacteraemia identified in our centre and 99 cases from the literature review were included. A major comorbidity was found in 80/119 (67.2%) patients. The death rate at 30 days was 31.1%. The most common comorbidities were cirrhosis, immunosuppressive therapy, and malignant diseases. Age was not associated with mortality. On multivariate analysis, the only factor associated with mortality was a major comorbidity (odds ratio 2.78, 95% confidence interval 1.01-7.70; p = 0.04). CONCLUSIONS: This study confirms the high mortality rate and highlights the importance of the host background, independent of age, in Pasteurella bacteraemia. Clinicians should be aware of the comorbidities in cases of Pasteurella infection, due to the poor prognosis of bacteraemia.

Fowl cholera and acute heart rupture in a backyard turkey.

Pasteurella multocida is the causative agent of fowl cholera, an economically important disease of commercial and backyard poultry. Turkeys are particularly susceptible to fowl cholera; both backyard and commercial turkeys can succumb to disease. On April 10, 2018, a dead 9-mo-old male Bronze turkey was submitted to the California Animal Health and Food Safety Laboratory System (CAHFS)-Turlock branch for postmortem examination. History included previous housing and fighting with another male turkey, after which separation by a fence was instituted. Fighting continued, and depression and anorexia of 2 d duration was followed by acute collapse and death. At autopsy, blood clots markedly expanded the pericardium, and a tear was visible in the left ventricular free wall. Vegetative aortic valvular lesions were observed. Microscopically, infarcts were observed in kidney, liver, heart, spleen, and pancreas, with large numbers of gram-negative bacterial colonies present in most organs. P. multocida was isolated from multiple organs, and identified as serotype 2,5 and fingerprint 1604. Septic embolization from the vegetative valvular aortic lesions likely led to infarcts in multiple organs, including the left ventricular free wall, which ultimately caused weakening of the ventricular wall, ventricular rupture, and exsanguination into the pericardial space. Rupture of the left ventricular free wall has not been previously documented in turkeys with P. multocida infection, to our knowledge, and demonstrates an atypical presentation of fowl cholera in this backyard turkey.

An unusual case of Pasteurella multocida bacteremic meningitis.

Pasteurella multocida is a rare cause of bacterial meningitis, more frequently affecting humans at the extremes of age. We report a case of meningitis and bacteremia caused by P. multocida in a 67-year-old diabetic woman who was living with 10 cats. She didn't have any animal bites or scratches, but she reported kissing the pets in the mouth. The outcome was favorable following antimicrobial treatment. Although rarely encountered, P. multocida should be considered as a possible cause of meningitis, particularly when Gram-negative coccobacilli are revealed in the cerebrospinal fluid and a history of recent animal contact is present.

Shock séptico de origen ginecológico por Pasteurella multocida / Septic shock of gynecological origin by Pasteurella multocida

La Pasteurella multocida es una gammaproteobacteria oportunista que produce una zoonosis caracterizada clínicamente por desarrollar cuadros mayoritariamente respiratorios como neumonía y rinitis atrófica, aunque las manifestaciones clínicas pueden derivar de la colonización de tejidos vascularizados y partes blandas de casi cualquier órgano, produciendo hemorragias, dermonecrosis, celulitis, meningitis, abscesos, septicemia, osteomielitis o endocarditis, entre otras. Este microorganismo se transmite a los humanos a través de mordeduras, arañazos o lesiones producidas por animales domésticos (especialmente gatos y perros), pero también salvajes. El diagnóstico es eminentemente clínico, apoyándose también en una anamnesis pormenorizada, y confirmándose mediante el crecimiento bacteriano en medios de cultivo como el agar sangre o el agar chocolate, de las muestras obtenidas de los pacientes afectados por esta rara infección. La antibioterapia con B-lactámicos durante 2 o 3 semanas, es la base terapéutica de este cuadro, aunque existe un alto porcentaje de pacientes con resistencia a los mismos, pudiendo necesitar terapias basadas en otros antibióticos como carbapenem, fluoroquinolonas o tetraciclinas. Las líneas de investigación más actuales están dando una gran importancia a los procedimientos de inmunización en animales domésticos, ya que por una parte son los principales vectores de transmisión y, por otro lado, la vacunación en humanos ha demostrado no ser efectiva, debido a la baja prevalencia de esta enfermedad en las personas expuestas. A continuación, presentamos el caso de una paciente con antecedentes de miomas uterinos y convivencia con gatos domésticos, que sufre un shock séptico por Pasteurella multocida, que tiene como principal foco infeccioso su útero miomatoso.

Pasteurella multocida is an opportunistic gammaproteobacteria which produces a zoonosis characterized clinically by developing majority respiratory pneumonia and atrophic rhinitis, even the clinical manifestations can be derived from the colonization of vascularized tissue and soft tissue of almost any organ, causing bleeding, dermonecrosis, cellulitis, meningitis, abscesses, sepsis, osteomyelitis or endocarditis, among others. This organism is transmitted to humans through bites, scratches or injuries caused by pets (especially cats and dogs), but also animals wild. The diagnosis is clinical, also leaning on a detailed anamnesis, and confirming through the bacterial growth in culture medium such as blood agar or chocolate agar samples from patients affected by this rare infection. With B-lactam antibiotic therapy for 2 or 3 weeks, is therapeutic base, although there is a high percentage of patients with resistance to them, and may need therapies based on other antibiotics as carbapenem, fluoroquinolones or tetracyclines. The lines of research are giving great importance to immunization procedures in domestic animals, since on the one hand are the main vectors of transmission and, on the other hand, vaccination in humans has proven to be not effective, due to the low prevalence of this disease in exposed persons. Then, present the case of a patient with a history of uterine fibroids and coexistence with domestic cats, suffering septic shock by Pasteurella multocida, which has as its main infectious focus your fibroid uterus.

Pasteurella multocida ecthyma complicated by necrotizing fasciitis.

Necrotizing fasciitis is a serious infection of the skin and soft tissues. Pasteurella multocida is rarely reported to cause necrotizing fasciitis and is associated with high mortality. We describe a female patient with a past medical history of diabetes mellitus and myeloproliferative disorder presenting with bullae and erythema of the right forearm secondary to P. multocida infection after possible cat bite. Despite adequate antibiotic coverage she developed necrotizing fasciitis diagnosed clinically and on diagnostic imaging. Patient was taken to the operating room emergently and underwent irrigation and debridement with subsequent split-skin graft. She recovered well after the surgeries and was discharge on intravenous antibiotics. At clinic follow-up, her wounds were healing well without any significant new symptoms.

Canine adenovirus type 1 and Pasteurella pneumotropica co­infection in a puppy.

In 2008, a 2 months-old male German shepherd was presented with fever, depression, and evident organic wasting. The puppy died within 48 hours after the onset of clinical signs. A complete necropsy was performed. Bacteriological examination of samples from the brain, lung, liver, spleen, and bone marrow tested positive for Pasteurella pneumotropica. Histopathology demonstrated inflammatory and vascular lesions in the central nervous system and internal organs. Canine adenovirus type 1 nucleic acid was detected by polymerase chain reaction in the frozen brain but not in the formalin-fixed, paraffin-embedded liver and lung samples. The positive PCR was subsequently confirmed by indirect fluorescent antibody testing of the paraffin-embedded brain and liver sections. Although the liver is the primary site of viral damage, these laboratory findings suggest that Canine adenovirus type 1 infection should be included in the differential diagnosis of neuropathological diseases in dogs and that adenoviral infections could promote septicaemia caused by opportunistic pathogens.

[Pasteurella canis hemorragic sepsis and empyema]. / Septicemia hemorrágica y empiema pleural por Pasteurella canis.

We report the case of a 56-year-old female patient, with a three-day history of hematemesis, melena, abdominal wall hematoma and epistaxis associated with thrombocytopenia and anemia. Idiopathic thrombocytopenic purpura was diagnosed and she was treated with dexamethasone for four days. The patient developed acute respiratory failure with signs of systemic inflammatory response. Blood and pleural fluid cultures grew Pasteurella canis. This is the first case, to our knowledge, of P. canis empyema associated with hemorrhagic septicemia without epidemiological background and the third case of septicemia caused by P. canis reported in the literature.

A Chronic Respiratory Pasteurella multocida Infection Is Well-Controlled by Long-Term Macrolide Therapy.

A 57-year-old woman with severe bronchiectasis frequently received antibiotics, including penicillin, for acute exacerbations due to Pasteurella multocida. Although the bacteria showed a decrease in antibiotic susceptibility, her symptoms and X-ray findings became stable, and severe exacerbations were not observed for the last few years after a low-dose erythromycin treatment was started. The development of a respiratory infection with Pasteurella multocida is relatively uncommon, but it can be controlled by immunomodulation which is associated with long-term macrolide therapy.

Septicemia hemorrágica y empiema pleural por Pasteurella canis / Pasteurella canis hemorragic sepsis and empyema

We report the case of a 56-year-old female patient, with a three-day history of hematemesis, melena, abdominal wall hematoma and epistaxis associated with thrombocytopenia and anemia. Idiopathic thrombocytopenic purpura was diagnosed and she was treated with dexamethasone for four days. The patient developed acute respiratory failure with signs of systemic inflammatory response. Blood and pleural fluid cultures grew Pasteurella canis. This is the first case, to our knowledge, of P. canis empyema associated with hemorrhagic septicemia without epidemiological background and the third case of septicemia caused by P. canis reported in the literature.

Comunicamos el caso de una mujer de 56 años de edad, con un cuadro clínico de tres días de evolución caracterizado por hematemesis, melena, hematoma en la pared abdominal y epistaxis, asociado a trombocitopenia y anemia. Con un probable diagnóstico de un púrpura trombocitopénico idiopático, se trató con dexametasona por cuatro días. Evolucionó con una insuficiencia respiratoria aguda con signos de respuesta inflamatoria sistémica, por un empiema pleural izquierdo con aislamiento de Pasteurella canis en hemocultivos y líquido pleural. Este es el primer caso, según nuestro conocimiento, de un empiema por P. canis asociado a una septicemia hemorrágica, sin antecedentes epidemiológicos; y tercero de una sepsis por P. canis publicado en el mundo.