Pasteurella multocida septic shock in chronic alcohol abusers: contamination of necrotic leg ulcers by domestic cat saliva

BACKGROUND: Pasteurella multocida septicemic septic shock without scratches in chronic alcohol abusers are rare and paucibacillar. Chronic legs ulcers could be predisposing factors. Three severe cases of such diseases with ea rly multiple organ failure without endocarditis despite 3, 5 and 3 positive blood cultures respectively are reported. CASE REPORTS: In all three cases, the source of septicemia was extensive sk in legs ulcers contaminated by domestic cat saliva, probably. The underlyin g diseases were alcoholism, without cirrhosis (2 cases) and with cirrhosis (1 case). Aggravating factors were present (chronic renal insufficiency, di abetes mellitus, non-steroidal anti-inflammatory agents) and they might hav e been responsible for pejorative outcome despite early appropriate empiric al antibiotic regimens. DISCUSSION: Because P. multocida SSC could be fulminant in chronic alcohol abusers with or without cirrhosis, we propose for these patients reducing e xposure to cats and hand-washing after exposure if wounds are present.