Pasteurella multocida bacteremia due to obstructive pneumonia in an immunocompromised patient

Abstract

Background Pasteurella multocida is a gram-negative pathogen commonly associated with soft tissue infections caused by bites or scratches from household animals. However, P. multocida infections have been reported without prior zoonotic exposure or associated soft tissue or skin infection in immunocompromised individuals. Case A 73-year-old patient with history significant for multiple malignancies including lung cancer presented to the emergency department with a fever, chills, and rigor. Patient denied any zoonotic exposure and did not have any soft tissue or skin structure infection. Laboratory testing and imaging revealed sepsis secondary to pneumonia and further lower respiratory cultures grew Pasteurella . Subsequent laboratory cultures indicated P. multocida bacteremia. Conclusion This case aims to advance awareness of the possibility of P. multocida infection in patients who do not have any known zoonotic exposure or identifiable skin or soft tissue infection. Nasopharyngeal colonization in immunocompromised individuals could be a source for invasive infection. Patients who have a pre-existing lung disease are susceptible for developing Pasteurella pneumonia, which can serve as the source of bacteremia.

Pasteurella multocida activates Rassf1-Hippo-Yap pathway to induce pulmonary epithelial apoptosis

“…Similarly, Pm-induced apoptosis of a large number of lung epithelial cells can lead to increased lung permeability and consequently extrapulmonary infections. Notably, Pm bacteremia and Pm-induced extrapulmonary injury are becoming more common in clinical conditions [46][47][48], suggesting that Pm-induced pulmonary permeability via inducing excessive epithelial apoptosis could be an important part of its pathogenesis. Indeed, our recent studies also indicate that a complete model of Pm infection consists of at least two phases, pulmonary infection phase and extrapulmonary infection phase, and that extrapulmonary infection phase contribute to the Pm-induced cytokine storm and is critical for host death (data not shown).…”

Pasteurella multocida activates apoptosis via the FAK-AKT-FOXO1 axis to cause pulmonary integrity loss, bacteremia, and eventually a cytokine storm

“…Nevertheless, there is a growing body of evidence indicating that P. multocida , including capsular type A, can both damage the host's respiratory system and leak into its blood circulation system (bacteremia), leading to extrapulmonary infections [ 19 – 21 ]. Notably, P. multocida bacteremia and P. multocida -induced extrapulmonary damage have become increasingly common in the clinic, suggesting that P. multocida -induced systemic infection could be an important part of its pathogenesis [ 22 – 24 ]. As a result, we hypothesized that a complete P. multocida infection model could comprise at least two phases: a pulmonary infection phase (Phase 1) and a systemic infection phase (Phase 2).…”