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Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
Pasteurella multocida multiple intrapelvic abscesses in a young woman with uterine cervical cancer
Keigo Kimura1, Hideharu Hagiya2, Norihisa Yamamoto2
1Laboratory for Clinical Investigation, Osaka University Hospital, Japan.
Abstract:
Pasteurella multocida, a zoonotic pathogen in humans, is known to be associated with skin and soft tissue infections following animal bites, but rarely causes visceral infections. We report a case of P. multocida-associated multiple intrapelvic abscesses in a young woman with uterine cervical cancer. A 29-year-old unmarried woman was referred to us because of prolonged high fever accompanying abdominal pain with muscular guarding. She had a domestic cat but denied of any bites or scratches before that. Computed tomography demonstrated ascites and multiple abscesses around her uterus. Her condition did not improve with an initial treatment with flomoxef, clindamycin, and azithromycin. Further, we performed percutaneous pus drainage and switched the antimicrobial therapy to a combination of piperacillin/tazobactam and minocycline for 10 days. Although P. multocida was isolated from vaginal culture, no organisms were isolated from the pus culture. However, further investigation with specimen-direct 16S rDNA analysis diagnosed P. multocida as possibly a single pathogen responsible for the intrapelvic infection. After taking oral levofloxacin for two weeks, no recurrence was reported. Although P. multocida is known as an animal-related pathogen, it can transmit to humans without apparent bites or scratches. The present case illustrates that P. multocida can cause intrapelvic abscess as a result of ascending genital infection.
Insights
Pasteurella multocida, a zoonotic pathogen, rarely causes visceral infections. This case shows it can cause intrapelvic abscesses in women through ascending genital infection, even without animal bites.
Area of Science:
- Infectious Diseases
- Microbiology
- Gynecology
Background:
- Pasteurella multocida is a zoonotic bacterium typically causing skin/soft tissue infections after animal bites.
- Visceral infections with P. multocida are uncommon in humans.
Observation:
- A young woman with cervical cancer presented with fever and abdominal pain.
- CT revealed multiple intrapelvic abscesses.
- Initial antibiotic treatment was ineffective.
Findings:
- P. multocida was identified via 16S rDNA analysis of an intrapelvic specimen, despite negative pus cultures.
- The patient was successfully treated with percutaneous drainage, targeted antibiotics (piperacillin/tazobactam, minocycline, then levofloxacin), and vaginal P. multocida isolation.
- This suggests an ascending genital infection route.
Implications:
- P. multocida can cause serious intrapelvic infections in women, potentially via ascending genital transmission.
- Diagnosis may require advanced molecular methods (16S rDNA) when cultures are negative.
- Highlights the importance of considering P. multocida in unexplained pelvic infections, even without a clear history of animal bites.
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