Sepsis by Pasteurella multocida in an Elderly Immunocompetent Patient after a Cat Bite.
Lara CaserzaGabriella PiattiAldo BonaventuraLuca LiberaleFederico CarboneFranco DallegriLuciano OttonelloGiulia GustinettiValerio Del BonoFabrizio MontecuccoPublished in: Case reports in infectious diseases (2017)
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.
Keyphrases
- computed tomography
- case report
- emergency department
- end stage renal disease
- dual energy
- newly diagnosed
- acute kidney injury
- ejection fraction
- positron emission tomography
- magnetic resonance imaging
- intensive care unit
- chronic kidney disease
- contrast enhanced
- image quality
- clinical trial
- septic shock
- randomized controlled trial
- staphylococcus aureus
- peritoneal dialysis
- heart failure
- oxidative stress
- magnetic resonance
- pulmonary hypertension
- postmenopausal women
- bone mineral density
- study protocol
- wound healing
- optic nerve
- mechanical ventilation