A Case of Recurrent Pasteurella Bacteremia in an Immunocompetent Patient with No Animal Bite

Abstract

Patient: Male, 61Final Diagnosis: Recurrent pasteurella bacteremiaSymptoms: Ankle painMedication: —Clinical Procedure: —Specialty: Infectious DiseasesObjective:Rare diseaseBackground:Pasteurella multocida is a gram negative-penicillin sensitive bacterium and is part of normal respiratory microbiota of animals (e.g., cats and dogs) and some birds. Various infections in humans, such as cellulitis, rarely bacteremia, endocarditis, meningitis, and septic arthritis, are a result of domestic cat or dog bites. These infections are rarely seen in an immunocompetent person, without an associated animal bite.Case Report:We present a case of refractory Pasteurella multocida bacteremia without any animal bite in an immunocompetent person.Conclusions:Pasteurella multocida bacteremia has been seen in immunocompromised patients and mostly after a cat or dog bite or scratch but might also happen in immunocompetent humans with only pet licking rather than biting, which might increase hospital and emergency department visits or admissions in the future.

Pasteurella multocida Bacteremia in an Immunocompromised Patient After Multiple Cat Scratches

“…Infrequent and unlikely complications such as meningitis, endocarditis, and septic arthritis have also been associated with P. multocida [ 6 , 7 ]. A case study by Clarke et al, treated a patient who presented with symptoms consistent with meningitis [ 7 ].…”

An Abrasion, a Prosthetic Shoulder, and a Cat with a Licking Tendency: Case Report and Literature Review of P. multocida Joint Seeding

“…In our patient, a history of multiple prosthetic joints significantly elevated the risks associated with bacteremia due to her increased susceptibility to joint seeding. While most documented cases of Pasteurella bacteremia are in patients who suffered animal bites and scratches, there are documented cases in which the source of the infection was considered to be licking of an existing wound or kissing of the animal [ 3 , 4 , 13 ]. Of significant interest is the fact that the patient was taking lenalidomide at the time of hospitalization.…”

“…In support of the hypothesis that the licking of an already existing wound led to infection with P. multocida , the patient has multiple dogs and cats and reported that one cat has a tendency to lick people and objects. Cases in which licking was considered to be a likely mode of transmission have been documented [ 4 , 62 ]. Additionally, one retrospective review noted that cases of P. multocida bacteremia where animal bites were not noted as the inciting event for infection were found to have poorer outcomes [ 63 ].…”

“…P. multocida infection has also been documented in the absence of bite wounds in patients with cat scratches present on physical examination [ 2 ]. Less commonly still are instances in which P. multocida is isolated from an individual where no wounds from animals are detected [ 3 , 4 ]. We present a case of P. multocida bacteremia in an immunocompromised patient, with a history of close contact with both cats and dogs but no bites or scratches, resulting in subsequent septic arthritis of the shoulder, epidural abscess, and spinal osteomyelitis.…”

Death by cat bite: Pasteurella multocida: Autopsy findings and review of the literature

“…[3] While immunocompromised patients have a higher rate of systemic infection and mortality, they are less likely to present with evidence of a bite wound. [1,4,5] We present a case of Pasteurella multocida bacteremia causing the death of an 80-year old immunocompromised female. While oropharyngeal colonization was the clinically suspected route of entry, a bite wound was ultimately discovered at autopsy.…”