Diabetes in patients with pasteurellosis

Purpura fulminans and severe sepsis due to Pasteurella multocida infection in an immunocompetent patient

A 75-year-old woman was admitted into the intensive care unit, with severe sepsis and renal failure. She developed purpura fulminans (PF) of bilateral upper and lower extremities along with gangrene on the tips of her fingers and toes. Blood cultures confirmed Pasteurella multocida as the causative organism. Despite aggressive supportive measures, the patient remained dependent on high doses of vasopressors and the gangrene progressed. She ultimately succumbed to her underlying severe sepsis. PF is a rare and fatal dermatological emergency commonly seen in children, but it also occurs in adults. Acute infectious PF occurs secondary to severe sepsis and P. multocida is a rare cause of PF. To the best of our knowledge, this is only the second reported case of PF due to P. multocida in an adult.

An unusual case of meningitis

Pasteurella multocida is a Gram-negative anaerobe that is known to colonize household pets; in fact, it has been reported to be present in a majority of cats and dogs. P multocida can cause a variety of infections in humans, of which skin infections are the most common. This article describes a case involving a 56-year-old man who developed meningitis caused by P multocida following tympanomastoidectomy. The authors discuss the treatment course and most likely route of infection in this case, and summarize the cases of P multocida-associated meningitis presented in the literature.

Pasteurella multocida is a rare cause of bacterial meningitis. A 56-year-old man with several pets developed a profoundly decreased level of consciousness following left tympanomastoidectomy. Lumbar puncture produced cerebrospinal fluid with the typical findings of meningitis (low glucose, high protein, high leukocytes). Cultures from the cerebrospinal fluid and a swab of the left ear revealed Gram-negative coccobacillus identified as P multocida. The organism was sensitive to ceftriaxone, ampicillin and penicillin, and a 14-day course of intravenous penicillin was used as definitive treatment, resulting in full recovery. Although rare, P multocida should be considered as a potential cause of meningitis in patients with animal exposure, particularly in the setting of recent cranial surgery.

Invasive Pasteurella multocida sinusitis in a renal transplant patient

Pasteurella are commensal gram-negative bacteria isolated from the oral cavity of many domesticated animals. Most human infections occur post animal bite or scratch injury resulting in local cutaneous infection; however, case reports suggest that transmission may occur via animal secretions. Pasteurella species can be associated with serious systemic infections particularly in those with underlying disease and in the immunocompromised. We present a case of invasive Pasteurella multocida sinusitis in an immunocompromised renal transplant patient most likely acquired from a pet dog through direct mucosal inoculation via licking.