Sepsis byPasteurella multocidain an Elderly Immunocompetent Patient after a Cat Bite

Abstract

Pasteurella multocida colonizes animal scratches and bites. This bacterium was described to cause sepsis or endocarditis mainly in immunocompromised patients. We report the case of a 92-year-old woman presenting at the Emergency Department with coma and fever a week after the bite of her cat. The cat bite was misdiagnosed at admission partly due to an underestimation of this event by the patient's relatives. An inflamed area localized at perimalleolar skin of the right leg was detected. Laboratory biomarkers of inflammation were elevated. The cerebral computed tomography (CT) scan with angiographic sequences showed a complete occlusion of right intracranial vertebral artery. Total body CT scan and abdominal echocardiography were negative for foci of infection. Three consecutive blood cultures were positive for Pasteurella multocida. A diagnosis of sepsis by Pasteurella multocida was made, and the patient recovered after a specific antimicrobial treatment. In order to confirm the animal transmission, the cat saliva was cultured and found positive for Pasteurella multocida with a similar antibiotic sensitivity to that isolated from the patient. In conclusion, the case of a patient with coma and fever after a cat bite was presented. The transmission of pathogens from pets has to be carefully considered as an important route of infection in immunocompetent patients.

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.…”

“…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 ].…”

Death by cat bite: Pasteurella multocida: Autopsy findings and review of the literature

“…These patients are more likely to have severe underlying comorbidities, including an immunocompromised state, and have higher rates of ICU admission and ultimately, mortality. [1,5,[7][8][9] It may be instructive that our patient was diagnosed with leukopenia and thrombocytopenia only a few weeks before her death. One can speculate that an underlying immunodeficiency increased her risk of systemic infection while also decreasing her body's ability to mount a successful local immune response, allowing the normal signs and symptoms of a local infection to be missed.…”

Endocarditis por Pasteurella multocida

“…La EI es, sin dudas, la enfermedad del corazón que exige la máxima colaboración multidisciplinaria por la diversidad de su presentación clínica, lo cual hace, inicialmente, sospechar una gama de otras enfermedades clínicas, y muchas veces se pierde la oportunidad de llegar al diagnóstico antes de que aparezcan las complicaciones 1 . Pasteurella multocida es una causa rara de EI que ocurre principalmente en pacientes inmunocomprometidos y se asocia con una alta tasa de mortalidad [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] . Se informa un caso atendido en el Hospital Británico.…”