Meningitis caused by Pasteurella multocida in a dog owner without a dog bite: clonal lineage identification by MALDI-TOF mass spectrometry

Abstract

BackgroundPasteurella multocida meningitis in an immunocompetent patient is rare and commonly occurs after animal bite. To our knowledge, only 48 cases have been reported in the literature since 1989. P. multocida meningitis is commonly linked to animal contagion. Here we report on a new case of P. multocida meningitis in an immunocompetent patient who is a dog owner without a dog bite. We used the matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry to investigate the clonal lineage between animal and human isolates.Case presentationIn our case, a 25-year-old immunocompetent French Caucasian woman with nothing notable in her medical history was admitted for meningitis caused by P. multocida. Clonal lineage of P. multocida strains from cerebrospinal fluid and blood culture and her dog’s oral cavity has been recognized by MALDI-TOF mass spectrometry dendrograms and clustering of the 21 P. multocida isolates in our centres. She was treated by a combination of intravenous ceftriaxone (2 g/day) and oral levofloxacin (1 g/day). She was discharged on the 6th day of admission. The antimicrobial therapy was conducted for 15 days. The dog was treated by clavulanic-acid amoxicillin for 3 weeks by the veterinarian. The evolution of the patient at the 5th month after the end of the antimicrobial therapy was normal without any neurological after-effects.ConclusionThe meningitis caused by P. multocida could be considered a cause of human meningitis in dog lovers without an animal bite. MALDI-TOF mass spectrometry should be considered as it is an accurate tool to identify clonal lineage between animal and human isolates.

Occurrence of Pasteurella multocida in Dogs Being Trained for Animal-Assisted Therapy

“…In fact, this non-pharmacological therapy has been performed in healthcare settings such as hospitals or healthcare facilities and is often aimed at patients belonging to risk categories (e.g., dialysis patients, Alzheimer’s disease patients, and immunosuppressed or immunocompromised patients) [ 7 , 38 , 39 , 40 ]. In line with the current literature, the zoonotic risk is much higher for immunocompromised people but is also present for immunocompetent people [ 23 , 24 , 25 , 41 ]. In recent scientific literature, different case reports of transmission to humans through licking and other forms of contact with dogs have been reported.…”

“…In addition, they performed a molecular genetic analysis of the P. multocida strains obtained by the patient and his dog, strongly suggesting a zoonotic transmission of this bacterium. Bardou et al [ 24 ] reported a case of P. multocida meningitis in a 25-year-old immunocompetent woman through contact with her dog’s saliva. Although the reported cases of infection are all individual, of the P. multocida infections, we underlined the variety of infected people (i.e., age, gender, immune status) and their respective clinical conditions.…”

“…Zoonotic transmission usually occurs through a bite from a dog and by contact with the animal’s saliva or nasal secretions [ 19 , 20 , 21 ]. Although cases of P. multocida infection have been reported more often in people from risk categories, such as young children, the elderly, pregnant women, or immunocompromised individuals [ 22 ], case reports of infection have also been reported in immunocompetent subjects [ 23 , 24 , 25 , 26 ]. In humans, P. multocida can cause serious infections, both invasive and localized, in the oral cavity, respiratory tract, and soft tissue, including pharyngitis, sinusitis, meningitis, tracheobronchitis, pneumonia, empyema, and abscess [ 10 , 18 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ].…”

Occurrence of Pasteurella multocida among pigs with respiratory disease in China between 2011 and 2015

“…Pasteurella multocida ( P. multocida ), a Gram-negative, non-motile, facultative coccobacillus, belonging to the Pasteurellaceae family [1], is an opportunistic pathogen and common inhabitant of the upper respiratory tract of many animal species, and a causative agent of numerous economically important diseases worldwide, including atrophic rhinitis (AR) in swine, fowl cholera in birds, pneumonia and shipping fever in cattle, snuffles in rabbits [2–4], and occasional zoonotic infections in humans [5]. …”

Pasteurella multocida meningitis with disseminated intravascular coagulation and multi-organ failure in an adult with no bite history

“…A recent case series reported that only 48 cases of Pasteurella multocida associated meningitis have been reported in literature in both healthy and immunocompromised adults as of 2015; 26% of these cases had had recent neurosurgery. 5 The American Pet Products Association estimates that 180 million dogs and cats live in the United States and that cats currently outnumber dogs by 12 million. Animal bites account for 1% (300,000) of annual emergency department visits and create health care expenditures of approximately $30 million per year.…”