Disseminated Pasteurella multocida in a patient with liver cirrhosis and spontaneous bacterial peritonitis – The role of cirrhosis-associated immune dysfunction

Disseminated Pasteurella multocida infection is rare and usually occurs in patients who are immunocompromised. Patients with liver cirrhosis seem to be particularly vulnerable; potentially related to cirrhosis associated immune dysfunction syndrome, frequently present in this population. While many patients report pet cat or dog bites or scratches, some patients develop infection even without obvious exposure, just from being in contact with animals. We present a patient with cellulitis and spontaneous bacterial peritonitis by Pasteurella multocida in whom infection disseminated and the patient developed bacteremia that seeded in the right acromioclavicular joint. We hypothesize that the port of entry for infection in our patient was contact with a pet cat through a chronic open leg wound. The patient was treated with intravenous ceftriaxone 2 g daily for 6 weeks and attained complete recovery.