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Arch Dis Child Fetal Neonatal Ed 2009;94:F373-F376 doi:10.1136/adc.2008.143982
  • Original article

Neonatal pasteurellosis: a review of reported cases

  1. N Nakwan1,
  2. N Nakwan2,
  3. T Atta3,
  4. K Chokephaibulkit4
  1. 1
    Neonatal Intensive Care Unit, Department of Pediatrics, Hat Yai Hospital, Songkhla, Thailand
  2. 2
    Department of Medicine, Hat Yai Hospital, Songkhla, Thailand
  3. 3
    Department of Pediatrics, Trang Hospital, Trang, Thailand
  4. 4
    Division of Infectious Diseases, Department of Pediatrics, Mahidol University, Bangkok, Thailand
  1. Correspondence to Narongsak Nakwan, Neonatal Intensive Care Unit, Department of Pediatrics, Hat Yai Medical Education Center, Hat Yai Hospital, Songkhla 90110, Thailand; nnakwan{at}hotmail.com
  • Accepted 2 February 2009
  • Published Online First 10 February 2009

Abstract

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 β-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.

Footnotes

  • Competing interests None.

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