Pasteurella multocida Spondylodiscitis in an Immunocompetent Patient

We present the case of an 82-year-old woman, previously independent in activities of daily living, who developed fever, myalgias, and headache over one week. Two weeks earlier, she had been treated with antibiotics for a lower respiratory tract infection. The patient had no history of immunosuppression and was a pet owner. She was admitted to the emergency department (ED) with a fever and multiple perforating wounds on her hands. Laboratory findings revealed elevated inflammatory markers, including C-reactive protein and procalcitonin, without an obvious infectious source. During observation and further investigations in the ED, her clinical condition rapidly deteriorated, requiring vasopressor support and subsequent transfer to the intensive care unit (ICU). Blood and urine cultures were obtained, and empirical broad-spectrum antibiotics were initiated. In the ICU, the patient developed severe neck pain with functional limitations. Cervical magnetic resonance imaging (MRI) revealed spondylodiscitis with C3-C4-C5 paramedian epidural empyema. Blood cultures identified Pasteurella multocida, and the patient was treated with intravenous ceftriaxone (2g every 12 hours) for eight weeks. A follow-up MRI at the end of treatment showed significant improvement, with a marked reduction in empyema and no need for surgical intervention. The patient was managed with a cervical collar and physical rehabilitation. At discharge, she had made substantial functional recovery, with no neurological deficits, and her inflammatory markers had returned to baseline.