Zoonotic bacterial meningitis in human adults

Abstract

Zoonotic bacterial meningitis is uncommon but is associated with specific complications. The suspicion should be raised in patients with bacterial meningitis who have recreational or professional contact with animals and in patients living in regions endemic for specific zoonotic pathogens. An immunocompromised state is associated with a worse prognosis. Identification of risk factors and underlying disease is necessary to improve treatment.

“My Dog Deafened Me!”: Case Report of Capnocytophaga canimorsus Infection and Literature Review

“…Local C. Canimorsus infection may be underdiagnosed because of the administration of effective empiric antibiotics. Giving the fact that postexposure antibiotic prophylaxis is commonly prescribed after a dog's bite, this may lead to negative CSF cultures and underestimation of the incidence of this zoonotic disease …”

“…These first‐line antibiotics are usually efficient against zoonotic pathogens. However, reduced susceptibility of C. canimorsus for trimethoprim/sulfamethoxazole and gentamicin has been described . Several studies have shown clindamycin to be the most active agent against Capnocytophaga spp.…”

“…Giving the fact that postexposure antibiotic prophylaxis is commonly prescribed after a dog's bite, this may lead to negative CSF cultures and underestimation of the incidence of this zoonotic disease. 12 Furthermore, CSF culture positivity has a mean time of 5 days, ranging from 1 to 19 days. 3 Blood cultures and CSF cultures were positive in a high proportion of zoonotic bacterial meningitis cases but regularly remained negative in meningitis caused by C. canimorsus.…”

Pasteurella multocidameningoencephalitis in an immunocompetent adult with multiple cat scratches

“…Infection has also been reported following non-traumatic contact, including kissing and being licked by animals and the pathogen has also been isolated in cases where no animal contact has occurred 3–6 . P multocida meningitis is most frequently reported in infants; it is a very rare cause of adult bacterial meningitis; a recent review article counted only 36 adult cases reported worldwide 7. Disseminated infection has more often been reported in those with predisposing factors such as advanced age, immune compromise, cirrhosis, renal replacement therapy or recent neurosurgical intervention 8.…”

“…P multocida is usually sensitive to third-generation cepahalosporins,7 which is recommended as first-line empirical therapy for presumed bacterial meningitis in most UK hospital guidelines. Most, but not all, isolates are sensitive to penicillin and ampicillin,11–13 and therapy can therefore be rationalised with antibiotic susceptibility patterns.…”