Mohammed HabashUniversity Hospital Galway, Ireland
Title: Spinal epidural abscess caused by Pastruella multocida following cat bite
Pasteurella multocida (P. multocida) is a non-motile, gram negative, coccobacillus. In cats, dogs and other domestic or wild animals, P. multocida can form part of their normal microbiota within the oral, nasopharyngeal and upper respiratory tract. Transmission occurs via animal bites, scratches and saliva contact with broken skin. Infection with P. multocida is most commonly associated with cellulitis, soft tissue infections, osteomyelitis and septic arthritis. To our knowledge there are four cases reporting an epidural abscess due to P. multocida where only one of those were associated with a cat bite.
A previously well 72 year old female with a recent history of cat bite presented to the emergency department with a history of fall, night sweats and trembling legs. The patient had an unexplained source of infection with signs of sepsis and elevated inflammatory markers. Her past medical history includes: diverticular disease, psoriasis, gout, hypertension, pulmonary hypertension and coronary artery disease. The patient is independent at baseline, lives at home and has a fifty pack year smoking history. Delay in diagnosis during admission led to systemic deterioration and rapidly progressing lower limb neurology was developing. An MRI was performed on day 9 of admission which identified an extensive lumbar spine epidural abscess compressing the cauda equina. Management was successful with intravenous antibiotics and urgent surgical decompression.