Pasteurella Endocarditis: A Case Report and Statistical Analysis of the Literature

Abstract

Pasteurella is a genus of commensal bacteria of the oral cavity of several domesticated animals and a common cause of cellulitis after animal bites. Pasteurella has also been reported as a rare cause of endocarditis, with only 35 prior cases of definite Pasteurella endocarditis in the literature. Here, we present a case of Pasteurella multocida endocarditis treated successfully with surgery and antibiosis, as well as a review of the literature with statistical analysis of correlations between risk factors and clinical outcomes, as well as between treatment choices and clinical outcomes. Despite the small sample size, our analysis indicates a statistically significant correlation between comorbid liver disease and mortality, as well as a significant negative correlation between surgical treatment and mortality. This analysis implies a need for surgical management of endocarditis due to Pasteurella species and for more aggressive management of Pasteurella endocarditis in the setting of comorbid liver disease.

Pasteurella multocida Endocarditis with Septic Arthritis: Case Report and Review of the Literature

“…11 Of these there were 24 cases of P. multocida endocarditis, 3-10,14-19,21-23, [31][32][33] seven cases of non-multocida Pasteurella endocarditis, 9,21,[26][27][28]30,31 and one case of undifferentiated Pasteurella endocarditis. 7 Seven cases (21%) had prosthetic valve endocarditis, 6,[18][19][20][21]27 while 17 patients (53%) had a predisposing cardiac condition 3,6,7,10,13,14,18,19,20,21,23,25,27 and 17 (53%) had other underlying comorbidities reported. 3,5,6,10,14,-16,19,22,26,27,29-31 Twenty-one patients (66%) had documented animal exposure, 3,4,6,8,10,11,13,14,[16][17][18][19][20]22,[25][26]…”

“…7 Seven cases (21%) had prosthetic valve endocarditis, 6,[18][19][20][21]27 while 17 patients (53%) had a predisposing cardiac condition 3,6,7,10,13,14,18,19,20,21,23,25,27 and 17 (53%) had other underlying comorbidities reported. 3,5,6,10,14,-16,19,22,26,27,29-31 Twenty-one patients (66%) had documented animal exposure, 3,4,6,8,10,11,13,14,[16][17][18][19][20]22,[25][26][27][28][29] of which 10 (31%) reported a bite, scratch, or contact of saliva with broken skin. Fever was the most common presenting symptom, afffecting 31 patients (97%), and 18 patients (56%) presented with systemic upset.…”

“…The mortality rate with surgery was 7% (1/14) and without surgery was 28% (5/18). Of the cases who died without surgery, two died within 24 hours of presentation and infective endocarditis was diagnosed at post-mortem examination; 13,19 one had an aortic root abscess, a bacteraemia with Burkholderia cepacia and a candidaemia; 6 one received only 2 weeks of antibiotics and then died later from heart failure; 6 and one of the patients died 9 days prior to an operation being performed from severe heart failure. 31 The patient who died after surgery presented with recurrence of infective endocarditis 6 weeks after his initial operation.…”

“…infective endocarditis cases concluded that all patients should be offered surgical intervention, unless an absolute contraindication exists given the difference in mortality rate. 19 However, they did not include a patient who died 4 months post-valve replacement from early prosthetic valve endocarditis caused by Pseudomonas aeruginosa. 20 The analysis was also limited by a lack of consideration of confounding factors such as comorbidity, which would skew the outcome in favour of surgery as surgical cases had a lower incidence of comorbidities.…”

Pasteurella Cerebral Mycotic Aneurysm: A Case Report and Review of the Literature

“…are pleomorphic, facultatively anaerobic, Gram-negative bacilli, which were first isolated by Louis Pasteur in 1880. These bacteria are commonly found in the upper respiratory tract and oral cavities of wild and domesticated animals, including dogs and cats [ 1 ]. Pasteurella spp.…”