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Published on: April 15, 2014
[Pasteurella multocida meningoencephalitis in a 14-year-old child]
L Kuoch1, F Villedieu1, G Favaretto2
1Service de réanimation pédiatrique, pôle Femme-Enfant, CHU de Caen, avenue Côte-de-Nacre, 14033 Caen cedex 9, France.
Abstract:
Pasteurella multocida is generally responsible for local infections through animal bites. It can be a cause of meningitis, which tends to affect people at the extreme ages of life or suffering from immunodeficiency. A 14-year-old teenager was hospitalized with typical signs of bacterial meningitis. P. multocida was evidenced in the cerebrospinal fluid. Progression was marked by a degradation on the 4th day of treatment, despite intravenous antibiotic therapy with third-generation cephalosporin, followed by a single seizure on the 7th day of treatment. The CT scan and magnetic resonance imaging showed pansinusitis but no intracerebral complications. Later progression was favorable, without neurological sequelae. The mode of contamination was inoculation via the upper airways with sinusitis. P. multocida meningitis is rare. The contamination does not always involve animal trauma.
Insights
Pasteurella multocida meningitis is rare, even without animal bites. This case highlights potential upper airway infection as a route for this serious bacterial meningitis.
Area of Science:
- Infectious Diseases
- Neurology
- Microbiology
Background:
- Pasteurella multocida typically causes localized infections, often from animal bites.
- Meningitis caused by P. multocida is uncommon, primarily affecting the very young, elderly, or immunocompromised individuals.
Observation:
- A 14-year-old presented with bacterial meningitis symptoms, with P. multocida identified in cerebrospinal fluid.
- Despite third-generation cephalosporin treatment, the patient experienced clinical decline and a seizure, with imaging revealing pansinusitis but no brain complications.
Findings:
- The patient's condition ultimately improved without neurological deficits.
- The route of infection was determined to be through the upper airways, associated with sinusitis, not direct animal trauma.
Implications:
- This case underscores that P. multocida meningitis can occur via respiratory inoculation, expanding the known transmission pathways.
- Healthcare providers should consider P. multocida in meningitis cases, particularly those with sinusitis, irrespective of animal contact history.
