C5 (Clinical Case) Coccobacillary Meningitis and Septic Embolic Infarcts in an Ex-Preterm Infant: An Unexpected Pathogen

Abstract Introduction/Background Pasteurella multocida causes life-threatening zoonotic invasive infections in immunocompromised individuals and those at extremes of age (neonates elderly). Bacteremia, meningitis, endocarditis are serious complications that associated with up to 25-30% mortality. Case Description A 7-week-old ex-34-week preterm female infant presented a one-day history fever, irritability, poor feeding without exposure sick contacts. Household contacts included constantly drooling Shi Tzu dog. Examination revealed an irritable, febrile bulging fontanelle scant purulent eye discharge. No focal neurological deficits, skin rashes or murmurs were appreciated. Empiric antibiotics initiated following full work-up for sepsis. Cerebrospinal fluid (CSF) analysis showed neutrophilic pleocytosis 7608 x106L nucleated cells (95% neutrophils), protein 7360 mg/L, glucose <0.2 mmol/L gram-negative coccobacilli. Blood CSF cultures grew multocida, prompting switch crystalline penicillin. An echogenic mitral valvular mass was identified the absence underlying cardiac defects. Head imaging confirmed ventriculitis multiple small infarcts. sequelae abscess, hydrocephalus hearing loss demonstrated after completion 6 weeks penicillin therapy. Discussion Haemophilus influenzae, serotype b, is typical cause coccobacillary meningitis infant. In addition non-b serotypes, non-typeable species which conjunctivitis may also disease young infants. The resultant growth P. from was, therefore, unexpected, particularly given there no preceding animal bites scratches. vulnerable hosts, this pathogen can be transmitted across mucous membranes close contact, such as licking sniffing. constant spraying saliva pet dog, flat-faced breed known have stenotic nares chronic nasal secretions, likely provided opportunity mucosal contamination. This infant’s age, prematurity, dog placed her high risk Pasteurellosis, manifested complicated endocarditis. Conclusion most often arise local bite scratch, rare but important severe infection, even trauma, Families at-risk who own pets should adequate education about address factors, including behaviour, presenting features preventive strategies reduce potential morbidity