Cirrhosis, cellulitis and cats: a ‘purrfect’ combination for life-threatening spontaneous bacterial peritonitis fromPasteurella multocida

Abstract

SummaryPasteurella multocida is a Gram-negative coccobacillus that colonises the upper airways of many animals, in particular, dogs and cats. It acts as an opportunistic infection in humans following an animal bite or scratch and is associated with soft tissue infections, septicaemia and pneumonia, particularly in patients with a compromised immune response, such as patients with liver failure. Spontaneous bacterial peritonitis (SBP) is a serious complication of cirrhosis with a death rate of 10-15%. We report a case of a 47-year-old man with cirrhosis who presented with life-threatening P multocida SBP and bacteraemia secondary to a lick from a cat to a cellulitic leg wound. This case highlights the potential severity of an infection from domestic animals and an otherwise innocuous organism in an immunocompromised host. BACKGROUND

Review article: spontaneous bacterial peritonitis – bacteriology, diagnosis, treatment, risk factors and prevention

“…One bacterium (monomicrobial) is the cause in more than 90% of cases, yet the probability of identifying a pathogen is mediocre as ascitic fluid cultures are positive in 50–60% of patients with SBP . Rare isolates reported in the literature include anaerobes, Aeromonas , Listeria , Streptococcus bovis , Bordetella bronchiseptica , Candida , Pasteurella multocida , Leclercia adecarboxylata , and Salmonella paratyphi A…”

Pasteurella multocida: from Zoonosis to Cellular Microbiology

“…Among the Pasteurella species, P. multocida is the predominant human pathogen encountered, especially in severe disease cases (235,239), although P. canis may be more prevalent with dog bites (48, [246][247][248]. Common symptoms of pasteurellosis in humans from animal bite wounds are swelling (edema), cellulitis (diffuse, localized inflammation with redness and pain), and bloody or suppurative/ purulent exudate (drainage) at the wound site (39, 41, 48, 49, 160,165,241,[249][250][251][252][253][254][255]. Leukocyte and neutrophil counts are typically high at the infection site, and inflammation develops very rapidly.…”

Zoonotic Bacteria Associated with Cats

“…16,17 Elderly patients with diabetes mellitus, hypertension, acquired immunodeficiency syndrome, malignancies and cirrhosis are the most vulnerable towards the development of such infections. Hey et al 18 reported a case of a 47-year-old man with cirrhosis who developed a life-threatening spontaneous peritonitis and bacteremia due to Pasteurella multocida following the lick from a cat on a cellulitic wound.…”