Pasteurella multocida meningitis presenting as fever without a source in a young infant

[Meningitis and osteitis caused by Pasteurella multocida in a three-month-old infant]

Pasteurella multocida is usually responsible for local infections occurring after animal bites. It can also be responsible for meningitis in infants. A three-month old infant was admitted to hospital with a diagnosis of bacterial meningitis and hip osteitis. Cultures of cerebrospinal fluid, blood and joint liquid were positive to Pasteurella multocida. Licking from the family dog was the transmission mode in this case. Despite initial neurological complications, clinical evolution was favourable after three weeks of intravenous antibiotic therapy followed by an oral administration for three months. Pasteurella multocida meningitis is rare in infants. It can be associated with arthritis, osteitis and septicaemia. Besides animal bites, licking is also a mode of contamination.

Molecular identification and epidemiological tracing of Pasteurella multocida meningitis in a baby

We report a case of Pasteurella multocida meningitis in a 1-month-old baby exposed to close contact with two dogs and a cat but without any known history of injury by these animals. 16S rRNA gene sequencing of the isolate from the baby allowed identification at the subspecies level and pointed to the cat as a possible source of infection. Molecular typing of Pasteurella isolates from the animals, from the baby, and from unrelated animals clearly confirmed that the cat harbored the same P. multocida subsp. septica strain on its tonsils as the one isolated from the cerebrospinal fluid of the baby. This case stresses the necessity of informing susceptible hosts at risk of contracting zoonotic agents about some basic hygiene rules when keeping pets. In addition, this study illustrates the usefulness of molecular methods for identification and epidemiological tracing of Pasteurella isolates.

In vitro activity of oral antimicrobial agents against clinical isolates of Pasteurella multocida

Pasteurella multocida causes a wide variety of infections and is the most common localized soft tissue infection after animal bite injuries. Penicillin or amoxicillin has been considered agent of choice for therapy. Reported beta-lactamase production by some isolates, the therapeutic dilemma of the penicillin allergic patient, and the polymicrobial nature of some infections led to this study of alternate antimicrobial agents. The in vitro activity of ampicillin, amoxicillin/clavulanate, cefprozil, cefuroxime, erythromycin, clarithromycin, trimethoprim/sulfamethoxazole, ciprofloxacin, and tetracycline were compared to penicillin against 73 geographically diverse isolates of P. multocida from human infections collected since 1991. MIC90 (microgram/mL) were as follows: penicillin < or = 0.06; ampicillin < or = 0.5; amoxicillin/clavulanate < or = 0.5; cefaclor 1.0; cefprozil 1.0; cefpodoxime 0.06; cephalothin 2.5; cefuroxime < or = 0.25; erythromycin 2.0; azithromycin 1.0; clarithromycin 4.0; trimethoprim/sulfamethoxazole < or = 0.5/9.5; ciprofloxacin < or 0.25; tetracycline < or = 2.0. No beta-lactamase producing isolates were found in this study. This in vitro study has identified alternate oral agents to penicillins that may be appropriate for therapy of P. multocida infections.

Sepsis puerperalis caused by a genotypically proven cat-derived Pasteurella multocida strain

We report a disseminated intrauterine Pasteurella multocida infection in a puerperal woman who could not remember any traumatic exposure to her cat. An oral swab taken from the cat, just 2 days after the patient's admission, grew Pasteurella multocida, with an PCR-fingerprinting pattern identical to the patient's isolate. Hand-washing after every contact with cats and dogs and if feasible separation of in-house pets from mother and infant should be applied to prevent this uncommon but serious occurrence of post-partum infections. To our knowledge this is the first case of Pasteurella multocida 'child-bed fever', with a genotypically identical strain isolated from the in-house cat.