Pasteurella multocida is well known as the primary cause of cat- and dog-bite wound infections. Bacteremia due to P. multocida is less frequently reported and less well studied.
In this article, we report 12 new cases of P. multocida bacteremia from our health system, and we review the adult (≥13 years of age) literature on this topic.
Results and Conclusions:
We found a total of 144 patients in our review with evaluable individual patient data and combined these patients with our 12 patients and analyzed the resulting 156 patients. The average age was 58 years, with 54% women and 46% men. Eighty percent of patients had animal contact. Almost all patients had chronic underlying illnesses, and almost all patients who died had significant immunosuppressive disorders. Sixty percent of patients had a positive blood culture, as the only positive culture, implicating P. multocida as the etiologic agent. Other sources of positive cultures included, in decreasing order of frequency, cerebrospinal fluid, wound drainage, joint aspirate, sputum, peritoneal fluid, and throat swabs. The most common clinical manifestations in decreasing order of frequency were septic shock/acute sepsis syndrome, pneumonia, endocarditis, spontaneous bacterial peritonitis, and pyogenic arthritis. Almost all patients received appropriate antimicrobial therapy, primarily because of the exquisite sensitivity of P. multocida to most antimicrobial agents. The mortality rate for P. multocida bacteremia was 22.6%. Patients with P. multocida bacteremia generally have significant underlying illnesses, protean manifestations, frequent animal contact, and a high mortality rate.