LAUSR

Dear Editor, There are rising concerns related to the high incidence of zoonotic diseases in humans, caused by close encounters with pets and other wild or domestic animals [1]. Pasteurella species are one of the most prevalent commensal and opportunistic infection-causing pathogens found in domestic and wild animals worldwide, and are part of the normal flora of the oral, nasal, and respiratory cavities in many animals such as dogs and cats [2]. Although Pasteurella mostly causes local wound infections in humans following animal bites or scratches, cases of infections including those of the bloodstream or respiratory system have also been reported for this opportunistic pathogen [3, 4]. However, to our knowledge, there is no report of pneumonic bacteremia caused by Pasteurella in Korea. We describe a case of a systemic infection of Pasteurella multocida in the bloodstream and respiratory system of a Korean patient. This study was exempted from review by the Institutional Review Board for Human Research, Yonsei University, Wonju Severance Christian Hospital (2017-12-0145). Informed consent from the patient was not required for this report because de-identified patient data was used. A 70-year-old man was admitted to Wonju Severance Christian Hospital because of abdominal pain and low blood pressure for one day. The patient also complained of coughing, a brownish blood-tinged sputum, rhinorrhea, heating sensation, chills, and chest discomfort. The patient had a medical history of hypertension, stable angina, pulmonary tuberculosis, chronic obstructive pulmonary disease, allergic rhinitis, and asthma. The patient does not breed any animals and did not report any contact with animals in the previous year. He was a chronic alcoholic with a more than 50-year history of heavy drinking, but had quit drinking one year prior to hospital admission and had no history of liver dysfunction. Physical examination revealed a low blood pressure of 76/52 mmHg and crackles on the right lower lung field. Laboratory findings showed an elevated white blood cell count of 21.3×10/L (94% segmented neutrophils) and serum C-reactive protein level (170.0 mg/L, reference: <3.0 mg/L). Chest computerized tomography showed consolidation in the right lower lobe. The patient was diagnosed as having community-acquired pneumonia and was empirically treated with cefoperazone-sulbatam and moxifloxacin. A blood specimen was incubated using two aerobic and anaerobic culture sets in the BacT/Alert 3D system (bioMérieux, Durham, NC, USA). After a 14-hour incubation period, gramnegative coccobacilli grew in the aerobic bottle and were identified as P. multocida by VITEK 2 systems (bioMérieux) using the gram-negative identification card (Bionumber 0001410100040001, bioMérieux). A sputum specimen was also inoculated on 5%