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Chest Infections |

Don't Smooch That Pooch! A Rare Case of Pasteurella multocida Pneumonia in an Elderly Woman

Nikunj Bhatt, MD; Angeline Lazarus, MD
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Walter Reed National Military Medical Center, Bethesda, MD


Chest. 2014;146(4_MeetingAbstracts):146A. doi:10.1378/chest.1988847
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Abstract

SESSION TITLE: Infectious Disease Cases II

SESSION TYPE: Affiliate Case Report Slide

PRESENTED ON: Wednesday, October 29, 2014 at 11:00 AM - 12:15 PM

INTRODUCTION: Pasteurella multocida is a Gram-negative coccobacillus that colonizes the naso-oropharynx of many domestic mammals. Zoonotic transmission to humans most commonly occurs after animal bites resulting in soft-tissue and skin infections, but pulmonary infections are possible. We report a rare case of pasteurella pneumonia in an elderly woman from kissing her pet dog.

CASE PRESENTATION: An 88 year-old nonsmoking woman with a history of well-controlled chronic obstructive pulmonary disease presented with a persistent nonpurulent cough, night sweats, and a weight loss of 12 lbs over 1 month. Physical examination and vital signs were unremarkable. A CT scan of the chest revealed multilobar tree-in-bud opacities associated with patchy areas of consolidation. Multiple sputum cultures were unremarkable and were negative for acid fast bacilli. A bronchoalevolar lavage was performed and cultures grew P. multocida. On further questioning, the patient revealed that she kisses her pet dog daily and her pet dog had a chronic cough as well. The patient and the dog (after veterinary consultation) were treated with amoxicillin-clavulanate for 2 weeks. The patient was advised to avoid kissing her pets. At 3 month follow up there was resolution of the pulmonary infiltrates on a CT scan and she reported no respiratory symptoms in herself or the pet dog.

DISCUSSION: Respiratory tract infection from P. multocida is rare, and the actual incidence is likely under-reported. Cases of pneumonia have been reported and the likely mechanism of transmission is by direct inhalation of contaminated aerosols or oral exposure to animal secretions. In the reported literature, pasteurella pneumonia is most frequently found in elderly patient with underlying lung disease that reside with cats and dogs. The treatment of choice for P. multocida infection is ampicillin-sulbactam if intravenous therapy is needed or oral amoxicillin-clavulanate.

CONCLUSIONS: We describe a rare case of a zoonotic transmission of pasteurella pneumonia. A history of animal exposure should alert the physician to consider Pasteurella multocida as a potential pulmonary pathogen. Our case further highlights that advising patients to avoid kissing pets can prevent zoonotic transmission of infections, especially in elderly patients with chronic lung diseases.

Reference #1: Klein NC, Cunha BA. Pasteurella multocida pneumonia. Semin Respir Infect 1997;12(1):54-56.

Reference #2: Marinella MA. Community-Acquired Pneumonia Due to Pasteurella multocida. Respir Care 2004;49(12):1528 -1529.

DISCLOSURE: The following authors have nothing to disclose: Nikunj Bhatt, Angeline Lazarus

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