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      Peritonitis Secondary to Uncommon Gram-Negative Coccobacillus Transmitted From a Cat in a Patient on Peritoneal Dialysis

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          Abstract

          Peritonitis caused by gram-negative organisms is a significant complication encountered in patients undergoing peritoneal dialysis and is associated with high morbidity and mortality. There has been recognition of peritonitis caused by uncommon organisms because of improved microbiological detection techniques. In this article, we report a rare case of peritonitis caused by Pasteurella multocida. We present a 58-year-old male on peritoneal dialysis with fever and abdominal pain. The peritoneal fluid was cloudy, and the analysis was consistent with peritonitis. The peritoneal fluid culture grew Pasteurella multocida. The patient was treated with a 3-week course of intraperitoneal ceftazidime, which resulted in the resolution of infection with the salvation of the peritoneal dialysis catheter. Patient education plays a very critical role in the prevention of peritonitis from Pasteurella multocida, particularly if patients have pets at home. The domestic pets should be kept away from the dialysis equipment and should not be allowed into the room during dialysis treatment. Incorporating the education in handing pets during the training session is the key aspect.

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          Pasteurella multocida Infections

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            Pasteurella multocida and immune cells.

            Pasteurella multocida was first discovered by Perroncito in 1878 and named after Louis Pasteur who first isolated and described this Gram-negative bacterium as the cause of fowl disease in 1880. Subsequently, P. multocida was also found to cause atrophic rhinitis in pigs, haemorrhagic septicaemia in cattle and respiratory diseases in many other animals. Among other factors such as lipopolysaccharide, outer membrane proteins and its capsule, the protein toxin (PMT) of P. multocida is an important virulence factor that determines the immunological response of the host's immune system. However, the exact molecular mechanisms taking place in cells of the innate and adaptive immune system are largely unknown for any of these virulence factors. Due to the obvious function of PMT on cells of the porcine skeletal system where it causes bone destruction, PMT was regarded as an osteolytic protein toxin. However, it remained unclear what the actual benefit for the bacteria would be. Recently, more attention was drawn to the osteoimmunological effects of PMT and the interplay between bone and immune cells. This review summarises the knowledge of effects of P. multocida virulence factors on the host's immune system.
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              Cat induced Pasteurella multocida peritonitis in peritoneal dialysis: a case report and review of the literature.

              A 7-year-old girl treated with peritoneal dialysis developed a peritonitis due to Pasteurella multocida after physical contact of the domestic cat with the dialysis machine. Only 25 of such cases have been reported, mostly concerning adults. We report the third case involving a child, together with a literature review.
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                Author and article information

                Journal
                J Investig Med High Impact Case Rep
                J Investig Med High Impact Case Rep
                HIC
                sphic
                Journal of Investigative Medicine High Impact Case Reports
                SAGE Publications (Sage CA: Los Angeles, CA )
                2324-7096
                14 December 2019
                Jan-Dec 2019
                : 7
                : 2324709619895165
                Affiliations
                [1 ]Kaweah Delta Medical Center, Visalia, CA, USA
                [2 ]Adventist Medical Center, Hanford, CA, USA
                [3 ]SUNY Upstate Medical University, Syracuse, NY, USA
                [4 ]Interfaith Medical Center, Brooklyn, NY, USA
                [5 ]Hanford Family Medicine Residency Program, Hanford, CA, USA
                [6 ]Ashland Bellefonte Cancer Center, Ashland, KY, USA
                Author notes
                [*]Sreedhar Adapa, MD, Division of Nephrology, Kaweah Delta Medical Center, 400 W Mineral King Ave, Visalia, CA 93291, USA. Email: sreedharadapa@ 123456gmail.com
                Author information
                https://orcid.org/0000-0001-5608-5654
                https://orcid.org/0000-0003-1953-8815
                Article
                10.1177_2324709619895165
                10.1177/2324709619895165
                6913050
                31838876
                248dc79a-dfe9-473f-bf80-c36568c22d01
                © 2019 American Federation for Medical Research

                This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( http://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 13 October 2019
                : 17 November 2019
                : 24 November 2019
                Categories
                Case Report
                Custom metadata
                January-December 2019
                ts1

                pasteurella multocida,cats,peritoneal dialysis,peritonitis,gram-negative coccobacilli

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