A case report of Pasteurella multocida meningitis in a patient with non-traumatic skull base defect

Abstract

Background Pasteurella multocida is a gram-negative coccobacillus that is primarily found in oropharynx of dogs, cats and other animals. It causes infections in human beings through contact with animal saliva in the form of licks, bites and scratches of animals colonized by the bacteria. Meningitis due to Pasteurella multocida is rare in immunocompetent individuals. We report a case of meningitis due to Pasteurella multocida in an immunocompetent patient. Case report A 30-year-old gentleman presented with 2-day history of fever and neck stiffness. 6 weeks earlier, he was treated as a case of bacterial meningitis. During that hospital stay, he was diagnosed to have bony defect in the sellar floor based on MRI head performed to evaluate for a prolonged history of CSF rhinorrhea. He was discharged and scheduled for an elective endoscopic endonasal/open repair of the skull base defect after resolution of meningitis. CSF findings during current admission also showed features of bacterial meningitis. CSF culture showed Pasteurella multocida sensitive to penicillin, ampicillin and ceftriaxone. Retrospective history revealed patient’s contact with stray cats as he used to feed them but there was no history of licks, bites. He was treated with intravenous ceftriaxone 2 g twice a day for 14 days with complete resolution of his symptoms. Conclusion Pasteurella multocida is an important cause of bacterial meningitis in patients with skull defect. Patients with traumatic or non-traumatic bony defect of skull should avoid contact with dogs and cats to prevent the spread of infection the central nervous system.

Pasteurella multocida Infection Presented With Frequent Diarrhea in the Cirrhotic Patient

“…Pasteurella multocida infection has been reported to cause serious infections in immunocompromised patients, including those with liver cirrhosis [1,2]. In addition to skin and soft tissue infections and pneumonia, which are relatively frequent, there have been reports of peritonitis [3], meningitis [4], and endocarditis [5]; however, there was only one report of Pasteurella bacteremia preceded by symptoms of enteritis [6]. In this study, we report the second case of P. multocida bacteremia preceded by frequent diarrhea.…”

“…Pneumonia and other respiratory tract infections are the second most common site of infection and are more likely to occur in patients with chronic obstructive pulmonary disease and other chronic respiratory diseases as comorbidities [8]. Peritonitis, meningitis, and pericarditis can also occur in immunocompromised patients with conditions such as cirrhosis, advanced age, chronic renal failure, malignancy, and diabetes mellitus [3,4,8]. However, there was only one report of bacteremia triggered by symptoms of enteritis such as frequent diarrhea [6].…”