title: Rapidly evolving conjunctivitis due to Pasteurella multocida, occurring after direct inoculation with animal droplets in an immuno-compromised host.
abstract: BACKGROUND
  The rare descriptions, in the literature, of ocular infections due to Pasteurella multocida include: endophtalmitis, keratitis and corneal ulcers, Parinaud's oculoglandular syndrome, and conjunctivitis. Here, we report a rare case of rapidly evolving conjunctivitis due to Pasteurella multocida, occurring after direct inoculation with animal droplets in an immuno-compromised host.
  
  
  METHODS
  A 69-year-old, Caucasian male was referred to our department with purulent conjunctivitis, occurring five days after chemotherapy for an angioimmunoblastic-T-cell-lymphoma, and thirty-three hours after being struck in his right eye by his sneezing Dachshund dog. Physical examination revealed purulent conjunctivitis of the right eye associated with inflammatory edema of both lids. Direct bacteriological examination of conjunctival secretions showed gram-negative bacilli and regular, grey non-hemolytic colonies appearing the next day on blood agar. The oxidase test was positive for these colonies. An antibiotherapy associating intravenous amoxicillin and amoxicillin/clavulanate was administered. The outcome was favorable in the next three days allowing discharge of the patient with amoxicillin (2 g tid per os).
  
  
  CONCLUSIONS
  This case report may be of interest for infectious diseases, ophthalmology or oncology specialists, especially nowadays with chemotherapy being administered in day care centres, where unusual home pathogens can be encountered in health related infections. In this case, previous animal contact and conjunctival samples showing Enterobacteriaceae like colonies with positive oxidase test were two important clues which could help clinicians to make the diagnosis of Pasteurella conjunctivitis in every day practice.
authors.affiliation: Service de Médecine Interne, Maladies Infectieuses et Immunologie Clinique, Hôpital Robert Debré, Avenue Général Koenig, 51100, Reims, France. anthonycorchia@gmail.com.
authors.forename: Anthony
authors.initials: A
authors.lastname: Corchia
authors.affiliation: Laboratoire de Bactériologie, Hôpital Robert Debré, Avenue Général Koenig, 51100, Reims, France. alimelette@chu-reims.fr.
authors.forename: Anne
authors.initials: A
authors.lastname: Limelette
authors.affiliation: Service d'Ophtalmologie, Hôpital Robert Debré, Avenue Général Koenig, 51100, Reims, France. beatrice.hubault@gmail.com.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Hubault
authors.affiliation: Service de Médecine Interne, Maladies Infectieuses et Immunologie Clinique, Hôpital Robert Debré, Avenue Général Koenig, 51100, Reims, France. arobbins@chu-reims.fr.
authors.forename: Ailsa
authors.initials: A
authors.lastname: Robbins
authors.affiliation: Service d'Hématologie Clinique, Hôpital Robert Debré, Avenue Général Koenig, 51100, Reims, France. aquinquenel@chu-reims.fr.
authors.forename: Anne
authors.initials: A
authors.lastname: Quinquenel
authors.affiliation: Service de Médecine Interne, Maladies Infectieuses et Immunologie Clinique, Hôpital Robert Debré, Avenue Général Koenig, 51100, Reims, France. fbanisadr@chu-reims.fr.
authors.forename: Firouze
authors.initials: F
authors.lastname: Bani-Sadr
authors.affiliation: Service de Médecine Interne, Maladies Infectieuses et Immunologie Clinique, Hôpital Robert Debré, Avenue Général Koenig, 51100, Reims, France. yohan.nguyen@wanadoo.fr.
authors.forename: Yohan
authors.initials: Y
authors.lastname: N'Guyen
mesh_terms: D000368:Aged; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000818:Animals; D003234:Conjunctivitis, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D004285:Dogs / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D016867:Immunocompromised Host; D007262:Infusions, Intravenous; D016399:Lymphoma, T-Cell / Q000473:pathology; D008297:Male; D010326:Pasteurella Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D016979:Pasteurella multocida / Q000302:isolation & purification*; D057805:Pets; D015047:Zoonoses / Q000382:microbiology*; D065093:beta-Lactamase Inhibitors / Q000627:therapeutic use
chemical_list: D065093:beta-Lactamase Inhibitors; D019980:Amoxicillin-Potassium Clavulanate Combination