# Pasteurella Bacteremia and Otitis Media With Effusion in a Cancer Patient Without Neutropenia: Lessons for Early Diagnosis Through History-Taking and Blood Cultures

## TL;DR

A breast cancer patient developed a rare Pasteurella infection from dog exposure, highlighting the need for early diagnosis through history and blood tests.

## Contribution

Highlights the importance of history-taking and blood cultures for early diagnosis of Pasteurella infections in non-neutropenic cancer patients.

## Key findings

- Pasteurella multocida bacteremia and otitis media occurred in a non-neutropenic cancer patient.
- Early diagnosis was achieved through blood cultures and history of animal exposure.
- Prompt antibiotic treatment led to full recovery without complications.

## Abstract

Pasteurella multocida often causes zoonotic infections, ranging from mild, localized cellulitis to severe sepsis, and can be life-threatening in immunocompromised patients. However, diagnosis can be challenging due to its varied and nonspecific symptoms. We report a case of P. multocida bacteremia and otitis media with effusion in a 49-year-old female breast cancer patient undergoing chemotherapy without neutropenia. The patient presented with a sore throat, which was followed by headache, ear fullness, and fever. She was initially diagnosed with a viral infection and sent home. Two days later, blood cultures revealed Gram-negative coccobacilli, which were later identified as P. multocida. The patient reported close contact with dogs but no bites or scratches. Further examination revealed otitis media with effusion. Treatment with ceftriaxone was initiated and subsequently switched from ceftriaxone to ampicillin, then to oral amoxicillin. The patient’s symptoms improved, and she was discharged without sequelae after 10 days of antibiotic therapy. Through a literature review, we identified a high rate of central nervous system complications associated with P. multocida acute otitis media, underscoring the necessity for early diagnosis. This case highlights the importance of thorough history-taking, including inquiry about animal exposure, and prompt blood culture acquisition in febrile cancer patients without neutropenia to ensure timely and effective management of potentially life-threatening infections.