Abstract Pasteurella species are a group of gram-negative anaerobic bacteria commensal to the oropharynx and gastrointestinal tract of domestic dogs and cats. While typically harmless in their host, these organisms can also act as opportunistic pathogens. Zoonotic transmission to humans typically occurs through animal bites and scratches, and less commonly through licking. Here, we present the case of a 72-year-old woman with pre-existing lung disease and persistent non-specific pulmonary symptoms who was found to have Pasteurella infection of the lungs. A 72-year-old woman with history significant for presumed idiopathic bronchiectasis presented to our outpatient pulmonary facility for persistent shortness of breath and cough productive of greenish sputum. Pulmonary function tests showed severe obstruction with incomplete bronchodilator response. She was trialed on a triple therapy inhaler with clearance therapy. Repeat CT imaging of the chest showed diffuse, progressive bronchiectasis, mosaic attenuation, reticulonodular opacities greatest in the upper lobes, and extensive bilateral clustered tree-in-bud changes with mucoid impaction. IgE and quantitative immunoglobulins were within normal limits. Aspergillus IgG was positive, but IgE and serum aspergillus antigen were negative. Connective tissue disease workup and sweat chloride testing were also negative. Due to persistent symptoms, bronchoscopy was performed, and cultures from bronchoalveolar lavage (BAL) fluid grew Pasteurella canis oralis and Aspergillus fumigatus. Upon further questioning, the patient noted that she had close contact with her two dogs at home, who frequently licked her face and mouth. She was treated with a two-week course of amoxicillin-clavulanate with significant improvement in her symptoms. Repeat CT performed 6 months later showed marked improvement in the reticulonodular opacities and stability in her underlying bronchiectatic airways. Most reported P. canis infections involve cat scratches or dog bites, often leading to skin and soft tissue infections, with the respiratory system being the second most common site of infection. This species has also been implicated in cases of bacteremia, endocarditis, osteomyelitis, and spondylodiscitis, often caused by bite wounds with subsequent seeding of infection. Human infection after non-bite exposure occurs via inhalation of contaminated secretions. Patients with pre-existing lung disease such as COPD, bronchiectasis, or malignancy are at highest risk. Penicillins, fluoroquinolones, newer-generation cephalosporins, and doxycycline have been used to treat Pasteurella infection with success. It is imperative to obtain a history of close animal contact in order to diagnose respiratory tract infections caused by Pasteurella species. This case highlights the risk of infection from pets in those with pre-existing lung disease. This abstract is funded by: None
Purzycki et al. (Fri,) studied this question.