Post-Operative Wound Infection by Multiple Zoonotic Organisms

Rhodococcus hoagii (formerly Rhodococcus equi), originally isolated from equine species, is primarily transmitted through inhalation of contaminated aerosols such as dust and even breath of infected livestock. Pasteurella multocida is a common cause of cellulitis secondary to canine and feline bites. These are 2 zoonotic microbes that can present with potentially life-threatening, systematic illness in immunocompromised patients. In this brief report, we delineate the clinical course of a 42-year-old post-operative patient (status post-elective exploratory laparotomy, extensive adhesiolysis, and excision of enterocutaneous fistula with creation of an end ileostomy) who developed multiple infections involving these two zoonotic microbes. The patient is an enthusiast of exotic animals with an extensive occupational history as a zookeeper. She was determined to be HIV negative but has a significant history of Crohn's disease managed with systemic immunosuppressive therapy. This case highlights her unusual constellation of post-operative infections and her subsequent medical management.