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BMJ Case Rep ; 20172017 May 03.
Article in English | MEDLINE | ID: mdl-28473359

ABSTRACT

We present the case of a 49-year-old woman admitted to our Acute Medical Unit with a 2-day history of fever, vomiting and confusion. The patient was alcohol dependent and had sustained several scratches from her pet cat, which her pet dog had licked. She deteriorated in the Emergency Department-developing high fever, worsening confusion and meningism. Blood cultures were taken and broad spectrum antibiotics commenced prior to CT scanning and diagnostic lumbar puncture. Blood cultures and CSF 16S ribosomal PCR confirmed a diagnosis of Pasteurella multocida bacteraemia and meningoencephalitis. The patient was successfully treated with 14 days of intravenous antibiotics. P multocida is a Gram-negative coccobacillus which frequently colonises the nasopharynx of animals; it is a recognised but very rare cause of meningoencephalitis in immunocompetent adults. This case highlights the need to consider P multocida infection in patients with prior animal contact, regardless of their immune status.


Subject(s)
Bacteremia/diagnosis , Bites and Stings/complications , Meningoencephalitis/diagnosis , Pasteurella Infections/diagnosis , Pasteurella multocida/isolation & purification , Animals , Anti-Bacterial Agents/therapeutic use , Bacteremia/drug therapy , Bacteremia/etiology , Cats , Diagnosis, Differential , Female , Humans , Immunocompetence , Meningoencephalitis/diagnostic imaging , Meningoencephalitis/drug therapy , Meningoencephalitis/etiology , Middle Aged , Pasteurella Infections/drug therapy , Pasteurella Infections/etiology , Tomography, X-Ray Computed
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