title: A rare case of neonatal sepsis/meningitis caused by Pasteurella multocida complicated with status epilepticus and focal cerebritis.
abstract: Pasteurella multocida is normally present in respiratory and digestive tract of many domestic and wild animals, but is a rare pathogen in neonatal infection. Here we describe for the first time a case of meningitis complicated by status epilepticus and right parietal lobe cerebritis. The patient showed a dramatic clinical onset characterized by septic appearance and prolonged seizures. Multidrug anticonvulsivant therapy was used to control the status epilepticus, but despite the aggressive treatment electrical crises were still evident 24 hours after the admission. Furthermore, a brain MRI, performed to investigate a persistent intermittent fever even if CSF became sterile, showed a focus cerebritis in the right parietal lobe, early stage of the cerebral abscess. Prolonged antibiotic therapy with steroids was requested to solve the cerebritis area. Interestingly, direct contact between the patient and domestic animals was denied by the family, but the father reported a contact with a rooster, killed and cooked few days before, suggesting, as previously described, that Pasteurella may also be transmitted through asymptomatic human carrier. The patient had a favourable outcome with no medium-term sequelae one month after discharge, but the severity of the clinical course and the unpredictable way of transmission highlight the importance of hygiene measures approaching infants.
authors.affiliation: Terapia Intensiva Neonatale-Neonatologia, ASO S. Croce e Carle, Cuneo, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Spadafora
authors.forename: G
authors.initials: G
authors.lastname: Pomero
authors.forename: A
authors.initials: A
authors.lastname: Delogu
authors.forename: L
authors.initials: L
authors.lastname: Gozzoli
authors.forename: P
authors.initials: P
authors.lastname: Gancia
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D001922:Brain Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008581:Meningitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D010326:Pasteurella Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016979:Pasteurella multocida / Q000302:isolation & purification; D011200:Poultry; D035583:Rare Diseases; D013226:Status Epilepticus / Q000188:drug therapy / Q000382:microbiology*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000927:Anticonvulsants; D005938:Glucocorticoids