Videos of babies being “kissed” by their dog are ubiquitous on social media — but now doctors are warning about the dangers of the trend, after a month-old baby developed meningitis from licks from the family pet.
The 33-day-old baby boy was admitted to hospital for an infectious workup following the incidental discovery of a 38.9°C rectal temperature during a routine health check with his primary care doctor.
A week previously, the infant had been evaluated by his paediatrician, after his mother reported he was “slightly fussier” than usual, wrote doctors from West Virginia University.
At the time, the paediatrician put this down to increased gassiness after feeding and prescribed a probiotic which seemed to settle the infant.
After being admitted to hospital for further examination the infant had an unremarkable physical examination, with a non-bulging fontanelle, and “consolable fussiness consistent with age”, the case authors report in Cureus.
“A limited sepsis workup was undertaken given the infant’s age, fever, and well appearance with no evident source of infection.”
Laboratory results were remarkable for a white blood cell count of 17.5×109/L (normal: 4.0-11.0) with an elevated absolute neutrophil count of 9.6 ×109/L and an elevated CRP of 34 mg/L.
In light of the high white blood cell count, a lumbar puncture was performed, and the CSF analysis was “concerning” for bacterial meningitis.
Doctors started the baby on IV vancomycin, ceftriaxone and acyclovir for empiric treatment of meningitis.
A Gram stain of the CSF did not show any organisms, but the cultures grew Pasteurella multocida within 22 hours of collection.
“Further history gathered from the parents revealed that the family had two pet dogs who frequently licked the patient to give him ‘kisses’,” they wrote.
“The parents denied any dog bites or scratches on the patient.”
The doctors noted P. multocida was a rare cause of meningitis in young babies, and was usually associated with cellulitis following a dog or cat bite.
By day four, the baby’s fever had subsided, and he had no complications for the remainder of his hospital stay.
After 21 days of IV ceftriaxone, he continued meeting milestones, with no neurological sequelae.
“Not only is the organism unusual but the well appearance of the infant made this diagnosis surprising,” the doctors wrote.
“The primary care provider played a vital role in her immediate recognition of an ominous symptom in this patient, allowing him to be promptly worked up and treated before his illness progressed.
“Furthermore, this case shows that even something seemingly innocent like a dog ‘kiss’ can result in serious illness in young infants.”
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More information: Cureus 2023; 20 Jun.