title: An angry cat causing Pasteurella multocida endocarditis and aortic valve replacement-A case report.
abstract: BACKGROUND
  Cat bite infections usually involve a mix of anaerobic and aerobic bacteria including species of Pasteurella, Streptococcus, Staphylococcus, Bacteroides, and Fusobacterium. We report a case of Pasteurella multocida infection from cat bites leading to endocarditis and subsequent aortic valve replacement.
  
  
  METHODS
  A 70-year-old male was admitted because of fever, tachycardia, and malaise. He had a history of alcohol abuse and was living alone with a cat in a rural area. A sepsis of unknown origin was suspected, and intravenous treatment with gentamicin and cefotaxime was initiated. Blood cultures yielded Pasteurella multocida, and the patient history revealed repeated cat bites. After four days, the patient was discharged with oral penicillin V treatment. Two weeks later, the patient returned with fever and a new systolic murmur. An aortic valve endocarditis was diagnosed, and it became clear that the patient had not completed the prescribed penicillin V treatment. The patient underwent a biological aortic valve replacement with debridement of an annular abscess, and the postoperative course was uneventful.
  
  
  CONCLUSIONS
  Endocarditis due to Pasteurella is extremely rare, and there are only a few reports in the literature. Predisposing factors in the present case were alcohol abuse and reduced compliance to treatment.
  
  
  CONCLUSIONS
  Cat bites are often deep, and in rare circumstances can lead to life-threatening endocarditis. Proper surgical revision, antibiotic treatment, and patient compliance are necessary components in patient care to avoid this complication.
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, SE-701 85 Örebro, Sweden; School of Health and Medical Sciences, Örebro University, SE-701 82 Örebro, Sweden. Electronic address: anders.ahlsson@regionorebrolan.se.
authors.forename: Anders
authors.initials: A
authors.lastname: Ahlsson
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, SE-701 85 Örebro, Sweden; School of Health and Medical Sciences, Örebro University, SE-701 82 Örebro, Sweden. Electronic address: orjan.friberg@regionorebrolan.se.
authors.forename: Örjan
authors.initials: Ö
authors.lastname: Friberg
authors.affiliation: Department of Infectious Diseases, Örebro University Hospital, SE-701 85 Örebro, Sweden; School of Health and Medical Sciences, Örebro University, SE-701 82 Örebro, Sweden. Electronic address: jan.kallman@regionorebrolan.se.
authors.forename: Jan
authors.initials: J
authors.lastname: Källman
keywords: Aortic valve replacement; Case report; Endocarditis