Severe Pasteurella multocida Infection in a Neonate: A Case Report and Literature Review.

Pasteurella multocida is a well-known cause of skin and soft tissue infections resulting from animal bites. The patient was a newborn male with no perinatal abnormalities except for a cephalohematoma on the left parietal region. At 10 days of age, he had a bite wound to the cephalohematoma from an indoor dog. The wound was very mild and there was no bleeding. At 12 days of age, he visited a local hospital with a fever and poor feeding. At presentation, he was in septic shock and was transferred to the intensive care unit of the hospital. On day three of hospitalization, P. multocida was identified in the blood culture. On day four of hospitalization, CT of the head revealed multiple low-density lesions in the cerebral parenchyma, and aspiration of the cephalohematoma was performed. A culture of the aspirated fluid also grew P. multocida. On day five of hospitalization, the patient underwent drainage of the cephalohematoma. The patient developed hydrocephalus and worsening cerebral edema injuries, ultimately resulting in severe neurological sequelae. We summarized previous reports on P. multocida infections in children 60 days old or younger. Of the reported cases, neonates accounted for a majority of cases. In addition, nontraumatic exposure was more common than traumatic exposure. The patients requiring surgical intervention and those with neurological sequelae were all neonates. Neonatal P. multocida infection can cause severe systemic illness and neurological sequelae, even in the absence of traumatic exposure.