Neonatal pasteurellosis: a review of reported cases

Background: Pasteurellosis is an uncommon infectious disease in humans mainly caused by Pasteurella multocida infection in neonates and has been rarely reported. Objectives: To review the literature and address the mode of transmission, clinical presentation, laboratory diagnosis, treatment, outcome and potential risk factors related to neonatal pasteurellosis. Methods: A Medline all-languages database search for neonatal (birth-1 month) pasteurellosis cases after 1950 was conducted. Individual references from each publication were also reviewed to identify additional cases. Results: Thirty-two cases were found, but detailed information was available for this review in only 25 cases. The median age was 14 days (range: birth-30 days). All were infected with P multocida. Animal exposure to cats and/or dogs was the major risk of infection: non-traumatic exposure in 11 (44%) cases, and traumatic exposure in 2 (8%) cases. Infections in 11 (44%) cases were classified as vertical transmission. The clinical features were most commonly bacteraemia with or without meningitis. The age at onset of 72 h or older was significantly associated with meningitis (>= 72 h of age: 13/14 vs <72 h of age: 3/11, p = 0.002). The most used antibiotics were P-lactam with or without aminoglycoside or chloramphenicol. The overall mortality was 20% (5/25). The age at presentation of <72 h, birth weight of <2500 g, and vertical transmission were independently associated with death. Conclusion: Pasteurellosis is a rare bacterial infection in neonates and should be considered in the cases of sepsis with history of exposure to domestic animal in either the patient or the mother.