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Exposure to domestic cats: risk factor for Pasteurella multocida peritonitis in liver cirrhosis?
C A Koch1, C L Mabee, J A Robyn
1Department of Medicine, Ohio State University Medical Center, Columbus 43220, USA.
Abstract:
Pasteurella multocida is most commonly associated with acute skin and soft tissue infections following an animal bite or scratch. Peritonitis caused by P. multocida in patients with cirrhosis is rarely reported. We present a case of spontaneous bacterial peritonitis with P. multocida in a patient with cirrhosis, squamous cell cancer of the head and neck, and nontraumatic domestic cat exposure. Nasopharyngeal colonization with P. multocida, with subsequent transient bacteremia and seeding of the peritoneum in immunocompromised (particularly cirrhotic) cat-owners, could play an important pathogenetic role in the development of spontaneous bacterial peritonitis. A review of the literature showed that in nine of 13 patients with cirrhosis and P. multocida peritonitis, exposure to domestic animals was reported. The mortality rate is high in this setting, even with prompt antibiotic treatment. Preventive strategies for immuno-compromised patients should include minimization of animal contact, especially cats, which have a high carriage rate (70-90%) of P. multocida.
Insights
Spontaneous bacterial peritonitis from Pasteurella multocida is rare in cirrhosis patients. Cat ownership may increase risk due to nasopharyngeal colonization and subsequent infection, highlighting the need for preventive measures.
Area of Science:
- Infectious Diseases
- Hepatology
- Microbiology
Background:
- Pasteurella multocida typically causes skin infections after animal bites.
- Peritonitis due to P. multocida is uncommon, especially in patients with cirrhosis.
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