ABSTRACT
Pasteurella multocida is a rare cause of bacterial meningitis, more frequently affecting humans at the extremes of age. We report a case of meningitis and bacteremia caused by P. multocida in a 67-year-old diabetic woman who was living with 10 cats. She didn't have any animal bites or scratches, but she reported kissing the pets in the mouth. The outcome was favorable following antimicrobial treatment. Although rarely encountered, P. multocida should be considered as a possible cause of meningitis, particularly when Gram-negative coccobacilli are revealed in the cerebrospinal fluid and a history of recent animal contact is present.
Subject(s)
Bacteremia/diagnosis , Meningitis, Bacterial/blood , Meningitis, Bacterial/diagnosis , Pasteurella Infections/diagnosis , Aged , Animals , Anti-Bacterial Agents/therapeutic use , Brain/diagnostic imaging , Cats/microbiology , Diabetes Mellitus , Female , Humans , Mouth , Pasteurella Infections/cerebrospinal fluid , Pasteurella Infections/complications , Pasteurella Infections/transmission , Pasteurella multocida/isolation & purification , Pets/microbiology , Tomography, X-Ray ComputedSubject(s)
Bacteremia/microbiology , Meningitis, Bacterial/microbiology , Pasteurella Infections/microbiology , Pasteurella/genetics , Ampicillin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Bacteremia/cerebrospinal fluid , Bacteremia/drug therapy , Bacteremia/epidemiology , Humans , Infant, Newborn , Male , Meningitis, Bacterial/cerebrospinal fluid , Meningitis, Bacterial/drug therapy , Meningitis, Bacterial/epidemiology , Molecular Epidemiology , Pasteurella/classification , Pasteurella/isolation & purification , Pasteurella Infections/cerebrospinal fluid , Pasteurella Infections/drug therapy , Pasteurella Infections/epidemiology , Pennsylvania/epidemiologyABSTRACT
Bacterial and aseptic meningitis are characterized by distinctive lactic dehydrogenase isoenzyme patterns. No studies have quantified the dynamics of lactic dehydrogenase isoenzyme distribution during treated bacterial meningitis. We used a retrospective case-series design, and reviewed files of all neonates with bacterial meningitis who attended our pediatric tertiary medical center for 8 years period. We identified neonates in whom a repeated lumbar puncture was indicated. Findings of cerebrospinal fluid analysis, including levels of lactic dehydrogenase isoenzymes, were compared with an age-matched reference group. In two patients with meningitis, lumbar puncture with cerebrospinal fluid analysis was repeated because of inadequate response to treatment or initially obscure etiologic pathogens. Both patients had initially low levels of lactic dehydrogenase-1 and lactic dehydrogenase-2 and high levels of lactic dehydrogenase-4 and lactic dehydrogenase-5, similar to other patients with bacterial meningitis. The distribution pattern of lactic dehydrogenase isoenzyme normalized after adequate antibiotic treatment. In light of the encouraging results in these two patients, further studies are warranted regarding the value of lactic dehydrogenase isoenzyme measurements for follow-up purposes and for evaluations of response to treatment.
Subject(s)
L-Lactate Dehydrogenase/cerebrospinal fluid , Meningitis, Bacterial/enzymology , Pasteurella Infections/enzymology , Streptococcal Infections/enzymology , Anti-Bacterial Agents/therapeutic use , Humans , Infant , Infant, Newborn , Isoenzymes/cerebrospinal fluid , Meningitis, Bacterial/cerebrospinal fluid , Meningitis, Bacterial/drug therapy , Pasteurella Infections/cerebrospinal fluid , Pasteurella Infections/drug therapy , Retrospective Studies , Streptococcal Infections/cerebrospinal fluid , Streptococcal Infections/drug therapy , Time Factors , Treatment OutcomeABSTRACT
This is the first reported case of the successful treatment of Pasteurella multocida meningitis with aztreonam in a patient with multiple antibiotic allergies.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Aztreonam/therapeutic use , Bites and Stings/microbiology , Meningitis, Bacterial/drug therapy , Pasteurella Infections/drug therapy , Animals , Cats , Female , Humans , Meningitis, Bacterial/cerebrospinal fluid , Meningitis, Bacterial/microbiology , Microbial Sensitivity Tests , Middle Aged , Pasteurella Infections/cerebrospinal fluid , Pasteurella multocida/drug effects , Pasteurella multocida/pathogenicitySubject(s)
Anti-Bacterial Agents/therapeutic use , Bacteremia/microbiology , Meningitis, Bacterial/microbiology , Pasteurella Infections/microbiology , Pasteurella multocida/isolation & purification , Bacteremia/cerebrospinal fluid , Bacteremia/drug therapy , DNA, Bacterial/chemistry , DNA, Bacterial/genetics , Humans , Infant, Newborn , Male , Meningitis, Bacterial/cerebrospinal fluid , Meningitis, Bacterial/drug therapy , Pasteurella Infections/cerebrospinal fluid , Pasteurella Infections/drug therapy , Pasteurella multocida/genetics , Sequence Analysis, DNAABSTRACT
Pasteurella multocida is a rare cause of meningitis. We report a case of P. multocida meningitis following a recent neurosurgery procedure and review the 32 cases previously described.
Subject(s)
Craniotomy , Decompression, Surgical , Meningitis, Bacterial/etiology , Pasteurella Infections/etiology , Pasteurella multocida/isolation & purification , Postoperative Complications/etiology , Trigeminal Neuralgia/surgery , Adult , Aged , Aged, 80 and over , Animals , Cats , Chickens , Female , Humans , Male , Meningitis, Bacterial/cerebrospinal fluid , Meningitis, Bacterial/drug therapy , Meningitis, Bacterial/microbiology , Middle Aged , Pasteurella Infections/cerebrospinal fluid , Pasteurella Infections/drug therapy , Pasteurella Infections/microbiology , Postoperative Complications/cerebrospinal fluid , Postoperative Complications/drug therapy , Postoperative Complications/microbiologyABSTRACT
A high proportion of household pets are colonised by Pasteurella multocida. The organism can be transmitted to humans by contact with animal saliva and is a recognised, although rare, cause of meningitis in infancy. Intimate contact between infants and family pets should be discouraged.
Subject(s)
Meningitis, Bacterial/microbiology , Pasteurella Infections/microbiology , Pasteurella multocida/isolation & purification , Penicillins/therapeutic use , Cefotaxime/therapeutic use , Cephalosporins/therapeutic use , Humans , Infant , Male , Meningitis, Bacterial/cerebrospinal fluid , Meningitis, Bacterial/drug therapy , Pasteurella Infections/cerebrospinal fluid , Pasteurella Infections/drug therapyABSTRACT
An otherwise healthy 53-year-old woman underwent intracranial surgery for trigeminal neuralgia. One week later she developed meningitis and bacteremia caused by Pasteurella ureae and was treated successfully with antimicrobials. This organism is known to colonize the respiratory tract in certain individuals and is an extremely rare cause of meningitis or bacteremia. This is the first reported case of bacteremia in an adult.
