Rare case of septic shock combined with meningitis caused by Pasteurella multocida without a history of cat and dog bites.

BACKGROUND: Pasteurella multocida is a zoonotic pathogen that mainly causes local skin and soft tissue infections in the human body through cat and dog bites. It rarely causes bacteraemia (or sepsis) and meningitis. We reported a case of septic shock and meningitis caused by P. multocida in a patient without a history of cat and dog bites. CASE PRESENTATION: An 84-year-old male patient was urgently sent to the emergency department after he was found with unclear consciousness for 8 h, accompanied by limb tremors and urinary incontinence. In the subsequent examination, P. multocida was detected in the blood culture and wound secretion samples of the patient. However, it was not detected in the cerebrospinal fluid culture, but its DNA sequence was detected. Therefore, the patient was clearly diagnosed with septic shock and meningitis caused by P. multocida. The patient had no history of cat or dog contact or bite. The patient was subsequently treated with a combination of penicillin G, doxycycline, and ceftriaxone, and he was discharged after 35 days of hospitalisation. CONCLUSION: This report presented a rare case of septic shock and meningitis caused by P. multocida, which was not related to a cat or dog bite. Clinical doctors should consider P. multocida as a possible cause of sepsis or meningitis and should be aware of its potential seriousness even in the absence of animal bites.

Pasteurella multocida bacteraemia with liver abscess.

A previously healthy woman in her mid-70s presented with right upper quadrant abdominal pain, fever, intermittent chills and malaise for 1 week. She was clinically septic with raised inflammatory markers. Her blood culture revealed Pasteurella multocida, which was susceptible to penicillin and amoxicillin-clavulanic acid. CT of liver revealed an abscess of 8.0×7.9×8.5 cm at the left lobe of the liver. However, the abscess was not amenable for surgical or radiological drainage. She was a farmer and had close contact with her pet cats. She was occasionally scratched by her cats when caring for them. The liver abscess resolved completely without drainage after prolonged antimicrobial therapy of 109 days. She commenced on 63 days of intravenous antimicrobials and 46 days of oral amoxicillin-clavulanic acid. This case illustrated P. multocida bacteraemia with a large liver abscess in an immunocompetent adult after non-bite exposure.

Unusual Presentation of Lumbar Surgical Site Infection: A Case Study of Early Onset Pasteurella multocida Infection after Arthrodesis.

BACKGROUND Infection is a serious surgical complication that significantly increases morbidity rates and health care expenses. Most human Pasteurella multocida infections are soft-tissue infections caused by dog or cat bites. Pasteurella multocida (P. multocida) is present in the oral, nasopharyngeal, and upper respiratory tract microbiota among cats, dogs, and other domestic or wild animals. Here, we report a case of lumbar surgical site infection caused by this bacterium. CASE REPORT A 70-year-old diabetic and overweight woman had a Pasteurella multocida surgical site infection after lumbar arthrodesis carried out for lumbar stenosis associated with spondylolisthesis. The patient had been in contact with her cat and claimed to have simply slept with it in her bed. Multiple antibiotic therapies and 3 debridement-irrigations with change of spinal implants during the last revision were needed. CONCLUSIONS Infections caused by P. multocida are rare and most often occur as a result of animal scratches or bites, but can sometimes occur after simple contact with an animal. Surgical site infection of spinal arthrodesis due to Pasteurella multocida implies treatment difficulties. In case of Pasteurella multocida infection of lumbar spinal arthrodesis, even in the early period, implant removal seems to be useful to limit the appearance of biofilm more specific to this micro-organism.

[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.

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.

Lower respiratory infection in humans caused by pasteurella multocida.

BACKGROUND: Pasteurella (P.) multocida commonly occurs in the upper respiratory tract of healthy domestic pets, especially cats and dogs. People become infected by biting, scratching or direct contact with the animal's saliva. Inflammation develops in the wound and limits itself to the skin and subcutaneous tissue. P. multocida may cause respiratory tract infections and severe life-threatening complications. The study aimed to identify the lower respiratory infection in humans caused by P. multocida, to determine the potential source of infection and the associated symptoms, comorbidities and applied treatment. MATERIALS AND METHODS: Between January 2010 and September 2021, 14,258 patients underwent 16,255 routine flexible video bronchoscopy (FVB), and the same number of bronchoalveolar lavage fluid (BALF) samples for microbiological examination were taken. RESULTS: Microbiological examinations of the BALF only allowed the identification of six patients with P. multocida infection. All persons reported multiple scratches or bites and licking or kissing by their pets in the past. Productive cough with expectoration of mucopurulent discharge was the predominant symptom. CONCLUSIONS: A lower respiratory infection caused by P. multocida is not common in humans. It should be considered particularly in elderly patients with underlying diseases and exposure to cats and dogs.

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.

Condenações de carcaça suínas devido a doenças respiratórias revisão bibliográfica / Pork carcass condemnation due to respiratory diseases bibliographic review / Condena de canales de cerdo por enfermedades respiratorias revisión bibliográfica

As doenças respiratórias são um problema significativo na produção suína e podem levar à condenação de carcaças no abate. Entre os agentes causadores dessas doenças destacam-se o Actinobacillus pleuropneumoniae, Mycoplasma hyopneumoniae e a Pasteurella multocida. O Actinobacillus pleuropneumoniae é um patógeno altamente contagioso, que ocasiona hemorragia, pleuropneumonia purulenta e fibrosa. A Pleuropneumonia é amplamente distribuída e gera graves prejuízos para a suinocultura. O Mycoplasma hyopneumoniae ocasionador da pneumonia por micoplasma, doença respiratória crônica. As infecções originadas podem regular negativamente o sistema imunológico do hospedeiro e aumentar a infecção e assim a replicação de outros patógenos. A Pasteurella multocida é o agente causador de uma ampla gama de infecções levando a alto impacto econômico. Patógeno comensal e oportunista da boca, nasofaringe e trato respiratório superior. A identificação precoce e o manejo adequado desses agentes causadores de doenças respiratórias são fundamentais para minimizar a incidência de carcaças suínas. A adoção de medidas preventivas, como a vacinação e práticas de manejo adequadas, pode ajudar a prevenir a propagação dessas doenças e garantir a produção de carne suína segura e de alta qualidade para o consumo humano.(AU)

Respiratory diseases are a significant problem in pork production and can lead to condemnation of carcasses at slaughter. Among the causative agents of these diseases are Actinobacillus pleuropneumoniae, Mycoplasma hyopneumoniae and Pasteurella multocida. Actinobacillus pleuropneumoniae is a highly contagious pathogen that causes hemorrhage, purulent and fibrous pleuropneumonia. Pleuropneumonia is widely distributed and causes serious damage to pig farming. Mycoplasma hyopneumoniae causes mycoplasma pneumonia, a chronic respiratory disease. Originating infections can down-regulate the host's immune system and increase infection and thus replication of other pathogens. Pasteurella multocida is the causative agent of a wide range of infections leading to high economic impact. Commensal and opportunistic pathogen of the mouth, nasopharynx and upper respiratory tract. Early identification and proper management of these agents that cause respiratory diseases are essential to minimize the incidence of swine carcasses. Adopting preventive measures, such as vaccination and proper management practices, can help prevent the spread of these diseases and ensure the production of safe, high-quality pork for human consumption.(AU)

Las enfermedades respiratorias son un problema importante en la producción porcina y pueden provocar el decomiso de las canales en el matadero. Entre los agentes causantes de estas enfermedades se encuentran Actinobacillus pleuropneumoniae, Mycoplasma hyopneumoniae y Pasteurella multocida. Actinobacillus pleuropneumoniae es un patógeno altamente contagioso que causa hemorragia, pleuroneumonía purulenta y fibrosa. La pleuroneumonía está ampliamente distribuida y causa graves daños a la cría de cerdos. Mycoplasma hyopneumoniae causa neumonía por micoplasma, una enfermedad respiratoria crónica. Las infecciones que se originan pueden regular a la baja el sistema inmunitario del huésped y aumentar la infección y, por lo tanto, la replicación de otros patógenos. Pasteurella multocida es el agente causal de una amplia gama de infecciones que tienen un alto impacto económico. Patógeno comensal y oportunista de la boca, nasofaringe y tracto respiratorio superior. La identificación temprana y el manejo adecuado de estos agentes causantes de enfermedades respiratorias son fundamentales para minimizar la incidencia de las canales porcinas. La adopción de medidas preventivas, como la vacunación y prácticas de manejo adecuadas, puede ayudar a prevenir la propagación de estas enfermedades y garantizar la producción de carne de cerdo segura y de alta calidad para el consumo humano.(AU)

Development of ELISA-based diagnostic methods for the detection of haemorrhagic septicaemia in animals.

Haemorrhagic septicaemia (HS) is an acute infection of cattle and buffaloes caused by the B:2 serotype of Pasteurella multocida. This disease is highly endemic in South Asia. In some peracute cases, there is 100% mortality in infected animals within a few hours of infection. Therefore, timely diagnosis of infection may contribute to its treatment and control to minimize economic losses. The current work reported the development of ELISA-based assays for the detection of anti-P. multocida antibodies and pathogen i.e. P. multocida. Owing to high immunogenicity, membrane proteins (MPs) extracted from local isolates of P. multocida serotype B:2 (PM1, PM2, and PM3) were employed as a potential diagnostic antigen for the development of indirect ELISA (i-ELISA) to detect HS antibodies in animals. MPs extracted from PM1, PM2 and PM3 isolates showed very low heterogeneity; hence MPs from the PM3 isolate were selected for the development of i-ELISA. The concentration of MPs (as coating antigen) of 3.13 µg/well and test sera dilution 1:100 was found to be optimal to perform i-ELISA. The developed method was validated through the detection of anti-P. multocida antibodies in sera of mice, immunized with MPs and formalin killed cells from the three local isolates (PM1, PM2 and PM3) of P. multocida. The significantly higher antibody titer in immunized mice was determined compared to unimmunized mice with the cut off value of 0.139. To detect P. multocida directly from the blood of infected animals, whole cell-based ELISA (cb-ELISA) assay was developed. A better detection signal was observed in the assay where bacterial cells were directly adsorbed on plate wells as compared to poly L-lysine (PLL) assisted attachment at a cell concentration of 106 CFU and 107 CFU respectively. The developed assays can be scaled up and potentially be used for the rapid detection of HS antibodies to gauge the immune status of the animal as well as vaccination efficacy and pathogen detection.

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.

Pasteurella multocida Bacterial Meningitis in a 33-Day-Old Infant.

A 33-day-old previously healthy term female is admitted to the pediatric intensive care unit with fever, lethargy and bulging fontanel. Given concern for meningitis, a lumbar puncture is performed and empiric treatment is initiated. The cerebrospinal fluid culture results reveal Pasteurella multocida. The patient is treated with intravenous ampicillin for 3 weeks and discharged with close outpatient follow-up.

Pasteurella Endocarditis in a Patient with Rheumatic Mitral Valve Disease.

BACKGROUND As a common member of the oral bacterial flora of cats and dogs, Pasteurella multocida can cause skin and soft tissue infection in humans after bites, licks, or scratches from animals. Uncommonly, infection due to Pasteurella can cause sepsis in humans. Even more rare is the development of infectious endocarditis from a Pasteurella infection. CASE REPORT A 76-year-old woman presented with malaise and symptoms of fluid overload. Blood cultures were positive for Pasteurella multocida, and an echocardiogram was significant for mitral valve vegetation and severe biatrial enlargement. A diagnosis of Pasteurella endocarditis was made. Surgical intervention was recommended, but owing to the risk involved, the patient elected for conservative management involving long-term treatment with intravenous antibiotics. CONCLUSIONS While exceedingly rare, Pasteurella multocida can cause infectious endocarditis in patients with predisposing factors. This patient had a known history of rheumatic heart disease, which is believed to have caused the significant findings on imaging. To the best of our knowledge, our case is the only one to depict Pasteurella endocarditis in a patient with rheumatic heart disease and severe biatrial enlargement. It is the authors' belief that the rheumatic heart disease and remodeling of the heart increased her susceptibility to severe infection from Pasteurella. The purpose of this case is to describe the pathogenicity of an otherwise low-attack bacterial infection in an elderly patient with underlying structural acquired heart damage.

Femoral artery aneurysm with large hematoma from Pasteurella: case report and literature review.

BACKGROUND: Pasteurella multocida is a well-known gram-negative facultative anaerobe well known for its ability to cause soft tissue infections following animal bite or scratch. Here we present a case with mycotic aneurysm of the superficial femoral artery due to P. multocida infection. CASE PRESENTATION: A 62 year old male patient presented with worsening right leg pain and swelling. On examination, he was found to have profound swelling and erythema of the right medial thigh and tenderness to palpation. Computerized tomography showed findings suggestive of right femoral pseudoaneurysm with a large right medial thigh hematoma. Blood cultures grew P. multocida. Patient underwent emergent open resection of the mycotic aneurysm and vascular bypass surgery. Intraoperatively, the site was noted to be grossly infected with multiple pockets of pus which were drained and pus cultures grew P. multocida. The diagnosis of P. multocida bacteremia with right femoral mycotic aneurysm and thigh abscess was made. Patient received 6 weeks of intravenous ceftriaxone and recovered. CONCLUSION: Our case is the first report on infection of peripheral vessel with Pasteurella and highlights the importance of prompt surgical intervention and effective antibiotic treatment.

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 Multocida Urinary Tract Infection in a Susceptible Patient with Non-Traumatic Feline Contact.

Pasteurella multocida is a part of the normal oral flora of domestic animals. Humans can develop skin and soft tissue infections from P. multocida after traumatic animal contact, usually through bites and scratches from domestic animals. Although rare, there have been documented case reports where P. multocida has been isolated from patients even after minimal casual animal contact. Even rarer, is the isolation of P. multocida from urine. The few documented cases of urine isolation have been described in patients who have underlying medical conditions, particularly those with urologic abnormalities. Here we present a 34-year-old female patient with known congenital neurological and urological anomalies who developed a P. multocida urinary tract infection from casual contact with a household feline, a previously unrecognized risk factor for P. multocida UTI in anatomically susceptible individuals.

[Description of the case of adverse pasteurellosis in a cirrhosis patient. Case report].

The article describes a clinical case of an unfavorable course of pasteurellosis in a patient with liver cirrhosis. Possible variants of the clinical course, clinical and epidemiological data, on the basis of which pasteurellosis can be suspected, modern recommendations for antibiotic therapy are considered.

Development of a multiplex PCR assay for the detection of key genes associated with Pasteurella multocida subspecies.

The ability to distinguish among the subspecies of Pasteurella multocida isolates is important epidemiologically; however, classification at the subspecies level based on the results of conventional biochemical tests (fermentation of sorbitol and dulcitol) is reportedly not accurate in all cases. Therefore, we developed a rapid, multiplex PCR assay to differentiate among the 3 subspecies of P. multocida. The PCR assay includes the P. multocida species-specific primers KMT1SP6 and KMT1T7 as an internal amplification control, with a newly designed gatD (galactitol-1-phosphate-5-dehydrogenase)-specific primer pair (unique for subsp. gallicida), and primers targeting a 16S rRNA gene region specific for subsp. septica. The subspecies specificity of the PCR was demonstrated by applying the test to a collection of 70 P. multocida isolates, including the Heddleston serovar reference strains; all isolates and strains were assigned correctly. The PCR assay is a sensitive, specific, and highly effective method for the identification of P. multocida subspecies, and an alternative to biochemical test-based differentiation. A possible relationship was noticed between P. multocida subspecies and lipopolysaccharide (LPS) genotype; all but one of the subsp. gallicida strains were isolated only from avian hosts and represented L1 LPS genotype. Subsp. multocida and subsp. septica isolates were classified into 5 and 4 different LPS genotypes, respectively, of which L3 was the only LPS genotype shared between these 2 subspecies.