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• W3092925876 abstract "SESSION TITLE: Fellows Critical Care Posters SESSION TYPE: Fellow Case Report Posters PRESENTED ON: October 18-21, 2020 INTRODUCTION: Pasteurella multocida is a Gram-negative coccobacillus that is most often implicated in pet related infections stemming from dog and cat bites. In light of the increased acceptance of wild pets in the American household, it becomes increasingly important for the clinician to screen for pet-related infections in the right clinical setting. We present an unusual case of septic shock in an elderly woman due to Pasteurella multocida. CASE PRESENTATION: The patient is a 78-year-old woman with PMHx of hypertension, dyslipidemia, and hypothyroidism, who presented with altered level of consciousness after being found on the floor of her bathroom. Although the patient did not report any complaints, she was found to be febrile (Tmax: 39 C), tachycardic (108) and with an elevated lactic acid (3.5 mmol/l). Within 12 hours of admission, the patient’s mental status started to improve, however, she was noted to be hypotensive with BP 63/48 mm Hg, and with a non-anion gap metabolic acidosis (Bicarbonate 16 meq/L). Despite appropriate fluid resuscitation, the patient required initiation of vasopressors and broad-spectrum antibiotics. Her blood cultures subsequently grew Pasturella multocida that was sensitive to Ceftriaxone. As the patient’s mental status improved, she was able to provide details about domesticating blind ducks and having been scratched just days prior to her admission. Patient was weaned off the vasopressors, transferred to medical floor and eventually discharged with no further complaints on follow up. DISCUSSION: Pasturella infections are commonly reported as resulting from contact with dogs, cats, and other various animals as it is part of animal flora in the oropharynx and gastrointestinal tract . While ducks are noted to be carriers of Pasturella , rarely are they implicated in systemic sepsis from an animal bite, as presented here in this case report. Elderly patients and immunocompromised patients are at highest risk for severe infections with Pasturella . Our patient had multiple comorbidities including elderly age, hypertension, dyslipidemia, and hypothyroidism which may have made her more susceptible to a more severe infection with Pasturella. Most studies have shown susceptibility of Pasteurella multocida to penicillins, beta-lactams, carbapenems, second and third generation cephalosporins and tetracyclines . As such, severe infections are treated with intravenous antibiotics and localized infections with oral antibiotics. CONCLUSIONS: Due to an increasing prevalence of wild-pets and high mortality associated with septic shock in patients with co-morbidities, it is important for clinicians to have high clinical suspicion of Pasturella multocida in the setting of animal exposure. Reference #1: Narsana N, Farhat F. Septic shock due to Pasteurella multocida bacteremia: a case report. J Med Case Rep. 2015;9:159. Published 2015 Jul 11. doi:10.1186/s13256-015-0643-3 Reference #2: Klein NC, Cunha BA. Pasteurella multocida pneumonia. Semin Respir Infect. 1997;12(1):54–6 Reference #3: Liu R, Chen C, Cheng L, et al. Ducks as a potential reservoir for Pasteurella multocida infection detected using a new rOmpH-based ELISA. J Vet Med Sci. 2017;79(7):1264-1271. doi:10.1292/jvms.17-0124 DISCLOSURES: No relevant relationships by Moayyad Alziadat, source=Web Response No relevant relationships by Mourad Ismail, source=Web Response No relevant relationships by Haris Kalatoudis, source=Web Response No relevant relationships by Jacob Mathew, source=Web Response No relevant relationships by William Meng, source=Web Response No relevant relationships by Sushant Nanavati, source=Web Response No relevant relationships by Rutwik Patel, source=Web Response No relevant relationships by Anish Samuel, source=Web Response No relevant relationships by Shivanck Upadhyay, source=Web Response No relevant relationships by Aarohi Vora, source=Web Response" @default.
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• W3092925876 date "2020-10-01" @default.
• W3092925876 modified "2023-09-25" @default.
• W3092925876 title "A CASE OF SEPTIC SHOCK THAT QUACKED!" @default.
• W3092925876 doi "https://doi.org/10.1016/j.chest.2020.08.704" @default.
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