Neonatal pasteurellosis: a review of reported cases.

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 (> or = 72 h of age: 13/14 vs <72 h of age: 3/11, p = 0.002). The most used antibiotics were beta-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.