Pasteurella multocida Endocarditis

Abstract

Human infection with Pasteurella multocida is the leading cause of animal bite wound infection. Life-threatening infection may occur in patients with a variety of underlying disorders and an immunocompromised state. Infective endocarditis with P. multocida is very rare and only a few clinically diagnosed cases have been reported. Described here is an autopsy case of a 61-year-old man with polycystic kidney disease who had P. multocida bacteremia and acute infective endocarditis with multiple bacterial clumps involving bicuspid aortic valve. The organisms were gram negative. Apparently the sepsis with P. multocida was acquired via licking of leg ulcers by his pet dog, establishing an animal-related causal relationship. Because P. multocida is a very common flora of many animals, infection with this organism probably occurs more frequently than is commonly appreciated. High index of suspicion and early diagnosis, especially in immunocompromised patients, are warranted because the disease is potentially life threatening, yet is a readily treatable infection.

Pasteurella multocida: from Zoonosis to Cellular Microbiology

“…Leukocyte and neutrophil counts are typically high at the infection site, and inflammation develops very rapidly. In more severe cases, pasteurellosis can rapidly progress to bacteremia (fulminant sepsis) (41, 161,235,241,251,[256][257][258][259][260][261][262][263][264][265][266] and other complications such as osteomyelitis (inflammation of the bone) (155,165,(267)(268)(269), endocarditis (inflammation of the heart) (256,263,(270)(271)(272)(273)(274)(275)(276)(277)(278)(279)(280)(281)(282)(283)(284)(285), and meningitis (inflammation of the meninges) (53, 90, 159, 163, 165, 264, 286-293).…”

Important emerging bacterial zoonotic infections affecting the immunocompromised

“…Pasteurella multocida and other species of Pasteurella are also important dog and cat bite pathogens [52]. Sepsis, endocarditis, and osteomyelitis are more likely to occur in patients with compromised immune function [52,68].…”

“…Sepsis, endocarditis, and osteomyelitis are more likely to occur in patients with compromised immune function [52,68]. Non-bite exposure (scratches, mucosal contact) to dogs and cats has also been associated with Pasteurella bacteremia in immunocompromised people [46,106].…”

<i>Pasteurella multocida</i> Infective Endocarditis: A Possible Link with Primary Upper Respiratory Tract Infection

“…Immunosuppression is considered to be a risk factor for the infection. The causes of immunosuppression include alcoholic cirrhosis (19), diabetes mellitus (16) and kidney disease (20). Other identified risk factors include chronic obstructive pulmonary disease (16) and the licking of leg ulcers by pets (20).…”