Paraplegia From a Spinal Epidural Abscess Caused by Pasteurella multocida

Pasteurella multocida is a common cause of infection following bites or scratches caused by cats and dogs. It is a rarely reported and often overlooked pathogen. Typical presentation is a rapidly developing cellulitis at the infection site. Here we present a rare case of worsening lower extremity paraplegia due to a spinal epidural abscess caused by P. multocida. The patient was a 56-year-old female who had been experiencing several days of back pain, became septic and went on to develop paraplegia. Failure to improve prompted re-evaluation of the diagnosis with subsequent imaging notable for a spinal epidural abscess. Blood cultures grew P. multocida but were initially misidentified as Haemophilus influenzae and only with targeted antibiotic therapy and neurosurgical intervention did she begin to improve. Obtaining an animal history and knowing when to re-evaluate a diagnosis are essential skills for any clinician.