Pasteurella Empyema as a Complication of Postoperative Pleural Effusion Following Coronary Artery Bypass Grafting...

A 60-year-old male with a history of chronic obstructive pulmonary disease (COPD) and prior lung malignancy with radiation therapy presented with progressive dyspnea status post coronary artery bypass grafting (CABG) five weeks postoperative. Initial workup demonstrated bilateral pleural effusions that were originally attributed to postoperative complications, though thoracocentesis demonstrated hemorrhagic fluid. Pleural cultures were positive for Pasteurella species, confirming empyema consistent with a history of household exposure to domesticated cats, dogs, and turtles. The inpatient course was characterized by rapid deterioration with bacteremia and acute hypoxic respiratory failure, requiring mechanical ventilation. This case demonstrates that respiratory transmission of Pasteurella multocida in immunocompromised individuals can cause life-threatening, invasive disease without direct inoculation, emphasizing the importance of zoonotic pathogens and obtaining relevant exposure histories when evaluating pleural infections in immunocompromised populations.