Pasteurella Bacteremia in a Patient with Hepatocellular Carcinoma
Location
D.P. Culp Center Ballroom
Start Date
4-5-2024 9:00 AM
End Date
4-5-2024 11:30 AM
Poster Number
124
Name of Project's Faculty Sponsor
Rupal Shah
Faculty Sponsor's Department
Internal Medicine
Competition Type
Competitive
Type
Poster Presentation
Presentation Category
Health
Abstract or Artist's Statement
Infections with Pasteurella multocida, a gram-negative coccobacillus, typically affect the skin and soft tissues in individuals who are not immunocompromised. The bacteria, found in mouth and respiratory tract of both domesticated and wild animals, can be transferred to humans through bites, scratches, or contact with oral fluids. Pasteurella has a polysaccharide capsule, which helps it avoid the human immune response. Systemic infections caused by this organism is typically seen in those with reduced immunity and ability to phagocytize bacteria that are encapsulated. Our patient is a 59-year-old male with hepatocellular carcinoma and alcoholic cirrhosis. He came to the emergency department, where he was found to be hypotensive and tachycardic. A chest radiograph was notable for pleural effusion, consolidating in the right lower lobe. Other findings included a lactate level of 3.9 mmol/L (upper limit of normal: 2 mmol/L) and multiple wounds on bilateral lower extremities. The patient reported that the wounds were in contact with his cat’s salivary secretions. Subsequent blood cultures were positive for Pasteurella multocida. He was treated with intravenous meropenem and fluids. Radiographs of the lower extremity did not suggest osteomyelitis. The patient elected for hospice care, due to the presence of other comorbidities, and expired in the hospital soon after finishing his antibiotic therapy. Considering Pasteurella bacteremia in patients with wounds that have come into contact with animal secretions is important. Elderly individuals and those with reduced immune function are at higher risk of developing complicated presentations such as meningitis, endocarditis, osteomyelitis, and bacteremia. Complicated presentations can have a mortality rate of up to 30%. Treating Pasteruella bacteremia involves starting with empiric antibiotics while awaiting blood culture and antibiotic sensitivity reports. Beta-lactam antibiotics can be used to treat the condition; however, alternate antibiotics such as meropenem may be required depending on the antibiotic sensitivity reports.
Pasteurella Bacteremia in a Patient with Hepatocellular Carcinoma
D.P. Culp Center Ballroom
Infections with Pasteurella multocida, a gram-negative coccobacillus, typically affect the skin and soft tissues in individuals who are not immunocompromised. The bacteria, found in mouth and respiratory tract of both domesticated and wild animals, can be transferred to humans through bites, scratches, or contact with oral fluids. Pasteurella has a polysaccharide capsule, which helps it avoid the human immune response. Systemic infections caused by this organism is typically seen in those with reduced immunity and ability to phagocytize bacteria that are encapsulated. Our patient is a 59-year-old male with hepatocellular carcinoma and alcoholic cirrhosis. He came to the emergency department, where he was found to be hypotensive and tachycardic. A chest radiograph was notable for pleural effusion, consolidating in the right lower lobe. Other findings included a lactate level of 3.9 mmol/L (upper limit of normal: 2 mmol/L) and multiple wounds on bilateral lower extremities. The patient reported that the wounds were in contact with his cat’s salivary secretions. Subsequent blood cultures were positive for Pasteurella multocida. He was treated with intravenous meropenem and fluids. Radiographs of the lower extremity did not suggest osteomyelitis. The patient elected for hospice care, due to the presence of other comorbidities, and expired in the hospital soon after finishing his antibiotic therapy. Considering Pasteurella bacteremia in patients with wounds that have come into contact with animal secretions is important. Elderly individuals and those with reduced immune function are at higher risk of developing complicated presentations such as meningitis, endocarditis, osteomyelitis, and bacteremia. Complicated presentations can have a mortality rate of up to 30%. Treating Pasteruella bacteremia involves starting with empiric antibiotics while awaiting blood culture and antibiotic sensitivity reports. Beta-lactam antibiotics can be used to treat the condition; however, alternate antibiotics such as meropenem may be required depending on the antibiotic sensitivity reports.