[Septic shock caused by Pasteurella multocida in alcoholic patients. Probable contamination of leg ulcers by the saliva of the domestic cats].

BACKGROUND

Pasteurella multocida septicemic septic shock without scratches in chronic alcohol abusers are rare and paucibacillar. Chronic legs ulcers could be predisposing factors. Three severe cases of such diseases with early multiple organ failure without endocarditis despite 3, 5 and 3 positive blood cultures respectively are reported.

CASE REPORTS: In all three cases, the source of septicemia was extensive skin legs ulcers contaminated by domestic cat saliva, probably. The underlying diseases were alcoholism, without cirrhosis (2 cases) and with cirrhosis (1 case). Aggravating factors were present (chronic renal insufficiency, diabetes mellitus, non-steroidal anti-inflammatory agents) and they might have been responsible for pejorative outcome despite early appropriate empirical antibiotic regimens.

DISCUSSION: Because P. multocida SSC could be fulminant in chronic alcohol abusers with or without cirrhosis, we propose for these patients reducing exposure to cats and hand-washing after exposure if wounds are present.