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A case report of Pasteurella multocida meningitis in a patient with non-traumatic skull base defect
Mohamed Kamal Sabra1, Adeel Ahmad Khan1, Musaed Al Samawi2
1Department of Internal Medicine, Al Khor Hospital, Hamad Medical Corporation, Qatar.
Background:
Pasteurella multocida is a gram-negative coccobacillus that is primarily found in oropharynx of dogs, cats and other animals. It causes infections in human beings through contact with animal saliva in the form of licks, bites and scratches of animals colonized by the bacteria. Meningitis due to Pasteurella multocida is rare in immunocompetent individuals. We report a case of meningitis due to Pasteurella multocida in an immunocompetent patient.
Case Report:
A 30-year-old gentleman presented with 2-day history of fever and neck stiffness. 6 weeks earlier, he was treated as a case of bacterial meningitis. During that hospital stay, he was diagnosed to have bony defect in the sellar floor based on MRI head performed to evaluate for a prolonged history of CSF rhinorrhea. He was discharged and scheduled for an elective endoscopic endonasal/open repair of the skull base defect after resolution of meningitis. CSF findings during current admission also showed features of bacterial meningitis. CSF culture showed Pasteurella multocida sensitive to penicillin, ampicillin and ceftriaxone. Retrospective history revealed patient's contact with stray cats as he used to feed them but there was no history of licks, bites. He was treated with intravenous ceftriaxone 2 g twice a day for 14 days with complete resolution of his symptoms.
Conclusion:
Pasteurella multocida is an important cause of bacterial meningitis in patients with skull defect. Patients with traumatic or non-traumatic bony defect of skull should avoid contact with dogs and cats to prevent the spread of infection the central nervous system.
Insights
Pasteurella multocida can cause meningitis, especially in individuals with skull defects. Avoiding contact with pets like cats and dogs is crucial for preventing central nervous system infections.
Area of Science:
- Neurology
- Infectious Diseases
- Microbiology
Background:
- Pasteurella multocida, a Gram-negative coccobacillus, commonly inhabits the oropharynx of animals.
- Human infections typically result from contact with infected animal saliva via licks, bites, or scratches.
- Meningitis caused by P. multocida is uncommon in immunocompetent individuals.
Observation:
- A 30-year-old immunocompetent male presented with fever and neck stiffness, indicative of bacterial meningitis.
- The patient had a pre-existing bony defect in the sellar floor, identified during a previous hospitalization for meningitis and CSF rhinorrhea.
- Cerebrospinal fluid (CSF) cultures confirmed P. multocida, sensitive to penicillin, ampicillin, and ceftriaxone.
Findings:
- Pasteurella multocida meningitis occurred in an immunocompetent patient with a skull base defect.
- The patient had a history of feeding stray cats, suggesting a potential exposure route.
- Treatment with intravenous ceftriaxone for 14 days resulted in complete symptom resolution.
Implications:
- Pasteurella multocida is a significant pathogen causing bacterial meningitis in individuals with skull defects.
- Preventing CNS infections necessitates avoiding contact with dogs and cats for those with skull abnormalities.
- This case highlights the importance of considering P. multocida in meningitis, particularly in patients with underlying skull defects.
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