Pasteurella multocida meningitis in a two-day old neonate

Severe Pasteurella multocida Infection in a Neonate: A Case Report and Literature Review

Pasteurella multocida is a well-known cause of skin and soft tissue infections resulting from animal bites. The patient was a newborn male with no perinatal abnormalities except for a cephalohematoma on the left parietal region. At 10 days of age, he had a bite wound to the cephalohematoma from an indoor dog. The wound was very mild and there was no bleeding. At 12 days of age, he visited a local hospital with a fever and poor feeding. At presentation, he was in septic shock and was transferred to the intensive care unit of the hospital. On day three of hospitalization, P. multocida was identified in the blood culture. On day four of hospitalization, CT of the head revealed multiple low-density lesions in the cerebral parenchyma, and aspiration of the cephalohematoma was performed. A culture of the aspirated fluid also grew P. multocida. On day five of hospitalization, the patient underwent drainage of the cephalohematoma. The patient developed hydrocephalus and worsening cerebral edema injuries, ultimately resulting in severe neurological sequelae. We summarized previous reports on P. multocida infections in children 60 days old or younger. Of the reported cases, neonates accounted for a majority of cases. In addition, nontraumatic exposure was more common than traumatic exposure. The patients requiring surgical intervention and those with neurological sequelae were all neonates. Neonatal P. multocida infection can cause severe systemic illness and neurological sequelae, even in the absence of traumatic exposure.

[Pasteurella multocida meningitis with cerebral abscesses]

Pasteurella multocida is classically responsible for local soft tissue infections secondary to dog bites or cat scratches. It can be responsible for meningitis in infants and elderly persons. We report the case history of a 5-year-old male child admitted to our pediatric unit for meningitis. Cerebrospinal fluid analysis revealed an infection with P. multocida. The suspected mode of contamination was either from the saliva of a pet dog or through an unnoticed skull fracture sustained after an accident 1 year prior to the occurrence of meningitis. In spite of the neurologic complication (cerebral abscess), the progression was favorable after drainage of the abscess, 5 weeks of parenteral treatment, and 3 weeks of oral antibiotic therapy. Meningitis due to Pasteurella sp. is rare and can lead to neurologic complications. The notion of bites or scratches can be absent and the mode of contamination is sometimes difficult to unveil.

Pasteurella multocida: from zoonosis to cellular microbiology

In a world where most emerging and reemerging infectious diseases are zoonotic in nature and our contacts with both domestic and wild animals abound, there is growing awareness of the potential for human acquisition of animal diseases. Like other Pasteurellaceae, Pasteurella species are highly prevalent among animal populations, where they are often found as part of the normal microbiota of the oral, nasopharyngeal, and upper respiratory tracts. Many Pasteurella species are opportunistic pathogens that can cause endemic disease and are associated increasingly with epizootic outbreaks. Zoonotic transmission to humans usually occurs through animal bites or contact with nasal secretions, with P. multocida being the most prevalent isolate observed in human infections. Here we review recent comparative genomics and molecular pathogenesis studies that have advanced our understanding of the multiple virulence mechanisms employed by Pasteurella species to establish acute and chronic infections. We also summarize efforts being explored to enhance our ability to rapidly and accurately identify and distinguish among clinical isolates and to control pasteurellosis by improved development of new vaccines and treatment regimens.

Pasteurella multocida meningitis in newborns after incidental animal exposure

We present briefly 2 newborns with Pasteurella multocida meningitis following incidental household exposure to domestic pets and review 36 additional cases from the literature. Of 38 reported cases of P. multocida meningitis during infancy, 18 were less than or equal to 1 month of age. All but one of the infants less than 1 month of age had documented exposure to household dogs and/or cats, most only incidentally.

Meningitis and subgaleal, subdural, epidural empyema due to Pasteurella multocida

Pasteurella is a Gram-negative coccobacillus found in 70-90% of oral cavities of cats, and as well, is isolated from the digestive systems of dogs, rats, rabbits, monkeys, and other animals. Pasteurella multocida has been known to cause infections in humans, the most familiar being soft tissue infection after animal bites. However, this organism may affect a variety of systems, causing serious disease. Pasteurella multocida can cause septic arthritis, osteomyelitis, pneumonia, endocarditis, meningitis, and septicemia. We report a case of bacterial meningitis, subgaleal, subdural, and epidural empyema due to Pasteurella multocida by a rabbit licking that resulted in neurological complications and a prolonged recovery period.

Pasteurella multocida Sepsis and Meningitis in 2-Month-Old Twin Infants after Household Exposure to a Slaughtered Sheep

This article outlines 2 cases of Pasteurella multocida sepsis and meningitis in 2-month-old twins after their father was exposed to a sheep during a sacrifice celebration at home. These cases emphasize the necessity of respecting basic hygiene rules and the danger involved in animal sacrifice without suitable professional structure.

Pasteurella multocida: a case report of bacteremic pneumonia and 10-year laboratory review

Pasteurella multocida is a normal oral commensal in animals. Animal bites are often complicated by severe wound infection due to P. multocida, but systemic infection is rare. We report a patient with bacteremic pneumonia successfully treated with ceftriaxone and ciprofloxacin. We also review the clinical isolates of P. multocida reported by a major teaching hospital laboratory over a 10-year period. There were 23 patients, comprising the present case, 17 patients with wound infections following animal bites, one case of neonatal meningitis and associated maternal vaginal carriage of P. multocida, and three sputum isolates of doubtful significance.

Pasteurella multocida meningitis in an adult: case report

Pasteurella multocida is known to form part of the normal flora in the nasopharynx or gastrointestinal tract in many domestic and wild animals. Most human P multocida infections are soft tissue infections caused by dog or cat bites. Less commonly this bacterium is associated with infections affecting other organ systems of man. A case of fatal P multocida meningitis discovered at the necropsy of a 52 year old man is described. P multocida is an unusual causative agent of meningitis which tends to affect those at the extremes of age.

In vitro activity of oral antimicrobial agents against clinical isolates of Pasteurella multocida

Pasteurella multocida causes a wide variety of infections and is the most common localized soft tissue infection after animal bite injuries. Penicillin or amoxicillin has been considered agent of choice for therapy. Reported beta-lactamase production by some isolates, the therapeutic dilemma of the penicillin allergic patient, and the polymicrobial nature of some infections led to this study of alternate antimicrobial agents. The in vitro activity of ampicillin, amoxicillin/clavulanate, cefprozil, cefuroxime, erythromycin, clarithromycin, trimethoprim/sulfamethoxazole, ciprofloxacin, and tetracycline were compared to penicillin against 73 geographically diverse isolates of P. multocida from human infections collected since 1991. MIC90 (microgram/mL) were as follows: penicillin < or = 0.06; ampicillin < or = 0.5; amoxicillin/clavulanate < or = 0.5; cefaclor 1.0; cefprozil 1.0; cefpodoxime 0.06; cephalothin 2.5; cefuroxime < or = 0.25; erythromycin 2.0; azithromycin 1.0; clarithromycin 4.0; trimethoprim/sulfamethoxazole < or = 0.5/9.5; ciprofloxacin < or 0.25; tetracycline < or = 2.0. No beta-lactamase producing isolates were found in this study. This in vitro study has identified alternate oral agents to penicillins that may be appropriate for therapy of P. multocida infections.

Sepsis puerperalis caused by a genotypically proven cat-derived Pasteurella multocida strain

We report a disseminated intrauterine Pasteurella multocida infection in a puerperal woman who could not remember any traumatic exposure to her cat. An oral swab taken from the cat, just 2 days after the patient's admission, grew Pasteurella multocida, with an PCR-fingerprinting pattern identical to the patient's isolate. Hand-washing after every contact with cats and dogs and if feasible separation of in-house pets from mother and infant should be applied to prevent this uncommon but serious occurrence of post-partum infections. To our knowledge this is the first case of Pasteurella multocida 'child-bed fever', with a genotypically identical strain isolated from the in-house cat.

[Maternal and neonatal Pasteurella multocida infection]

BACKGROUND

Materno-fetal infection due to Pasteurella multocida is rare; it may be severe in the neonate.

CASE REPORT

A 27-year old woman was admitted at 37 weeks' gestation with a history of abdominal cramps. Twenty-four hours after delivery, the mother was febrile (40 degrees C) and was given intravenous cefotaxime (2 days), followed by cefpodoxime (15 days). The newborn was febrile and hypotonic 24 hours after birth; he received an infusion of hydroxyethylamidon and was given cefotaxime (3 days), netilmicin (6 days) and amoxicillin (10 days). Pasteurella multocida was isolated from placenta, blood and gastric fluid in the baby and in blood cultures and vaginal swab in the mother. It was established that the mother was bitten by her dog during the pregnancy and wounded a few days before delivery.

CONCLUSION

This neonate was infected during the delivery and the source of mother's contamination was easy to determinate: pet animals were kept by the family and there was an history of wounds during her pregnancy.