Spinal epidural abscess caused by Pasteurella multocida mimicking aortic dissection: a case report

Abstract

Background: Pasteurella multocida (P. multocida) forms part of the normal flora of many animals. Although it is a common causative agent of skin and soft tissue infection after an animal bite or scratch, in rare cases it can cause spinal infections in humans.

Case presentation: A 68-year-old immunocompetent woman presented with fever and sudden onset of severe back pain mimicking aortic dissection. No findings related to the pain were revealed on enhanced computed tomography or initial magnetic resonance imaging (MRI) of the spine. The patient was found to be bacteremic with P. multocida, although she had no apparent injury related to animal contact. Repeated evaluation by MRI with gadolinium-contrast established the diagnosis of spinal epidural abscess. The patient was cured by the rapid initiation of antimicrobial therapy without surgery.

Conclusions: We describe the successful treatment of an individual with a spinal epidural abscess due to P. multocida without surgery. P. multocida infections may occur as sudden presentations. Obtaining the patient history of recent animal contact is essential. Repeated MRI evaluation may be required when spinal infections are suspected. To the best of our knowledge, this is the first report which describes a case of spinal epidural abscess due to this organism.

Keywords: Bacteremia; Pasteurella multocida; Spinal epidural abscess; Zoonosis.

Fig. 1

Sagittal MRIs of the thoracic spine on the eighth hospital day. a T2-weighted image. b T1-weighted image. c T1-weighted image with gadolinium enhancement. The posterior epidural abscess extends from the Th5 level to the Th6 level (arrow). Internally, there is a high T2/fluid signal, low T1 and gadolinium-enhancement. An associated mass effect caused spinal canal stenosis and slight compression of the spinal cord, without cord signal changes