Pasteurella multocida meningitis in an adult: case report and review.

Pasteurella multocida is a rare cause of adult meningitis. Close animal contact prior to onset of illness is frequent and represents the usual mode of introduction of the organism. In reports of a total of 21 cases of P. multocida meningitis in adults (this case report and 20 described previously in the English-language literature), 18 researchers commented on the occurrence of animal contact: two cases (11%) involved cat bite, 13 (72%) involved animal contact without bite, and three (17%) occurred in the absence of recognized animal contact. Clinical presentation was typical of bacterial meningitides. Overall mortality rate was 30%. The best predictors of poor outcome were initial hemodynamic instability and age greater than 60 years. Documented bacteremia (40% of cases) was not predictive of higher mortality. Effective therapy is based on early recognition of the possibility of P. multocida meningitis and prompt initiation of treatment with penicillin, ampicillin, or a third-generation cephalosporin.