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.