Pneumonia and disseminated bacteremia with Pasteurella multocida in the immune competent host: A case report and a review of the literature.

Pasteurella multocida is primarily an opportunistic infection, most commonly of skin and soft tissue following animal bites particularly in the elderly and immunocompromised. While invasive disease with P. multocida has been documented in patients at high risk, such as those with organ transplants, malignancy, and cirrhosis, infections other than cellulitis associated with this pathogen are exceedingly rare in the immunocompetent population. We report a 70 year old Caucasian female with occurrence of a P. multocida pneumonia and resultant bacteremia in an immunocompetent host. Similar to prior case studies, the patient presented with a history of having significant exposure to animals at her residence. We undertook a review of the literature for reports of disseminated P. multocida in immunocompotent hosts in the absence of the typical presentation of cellulitis. Literature has suggested the possibility of nasal and oropharyngeal colonization of patients with frequent interactions with domestic animals, in whom periods of suppressed immune function may lead to activation of infection. P. multocida is commonly susceptible to most beta-lactams, including those utilized for the treatment of community acquired pneumonia. The utilization of macrolides should be avoided in these patients as susceptibilities are unpredictable, however fluoroquinolones maintain activity and may be an alternative therapy.