Pasteurella multocida meningitis in an adult: case report and review.
Pasteurella multocida is a rare cause of adult meningitis. Close animal contact prior to onset of illness is frequent and represents the usual mode of introduction of the organism. In reports of a total of 21 cases of P. multocida meningitis in adults (this case report and 20 described previously in the English-language literature), 18 researchers commented on the occurrence of animal contact: two cases (11%) involved cat bite, 13 (72%) involved animal contact without bite, and three (17%) occurred in the absence of recognized animal contact. Clinical presentation was typical of bacterial meningitides. Overall mortality rate was 30%. The best predictors of poor outcome were initial hemodynamic instability and age greater than 60 years. Documented bacteremia (40% of cases) was not predictive of higher mortality. Effective therapy is based on early recognition of the possibility of P. multocida meningitis and prompt initiation of treatment with penicillin, ampicillin, or a third-generation cephalosporin.
Department of Critical Care Medicine, Health Sciences Centre, Winnipeg, Canada.
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Kumar
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Devlin
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Vellend
D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001733:Bites and Stings / Q000150:complications*; D002415:Cats; D002481:Cellulitis / Q000150:complications* / Q000209:etiology; D005260:Female; D006801:Humans; D008581:Meningitis / Q000188:drug therapy / Q000209:etiology*; D010325:Pasteurella / Q000145:classification; D010326:Pasteurella Infections / Q000188:drug therapy / Q000209:etiology*