Management Strategies for Pasteurella multocida Infections in Implant-Based Breast Reconstruction: Review of the Literature and a Successful Nonsurgical Salvage Case.

Pasteurella multocida is a rare but clinically significant zoonotic pathogen in implant-based breast reconstruction, often related to pet exposure. Although implant infections typically lead to explantation, recent evidence-including our case-suggests that nonsurgical salvage may be possible in selected scenarios under close surveillance. In this report, the authors conducted a narrative review of the literature, identifying 5 previously reported P. multocida breast prosthesis infections and 1 Pasteurella canis case reviewed separately for broader zoonotic context. Among the 5 previously reported P. multocida cases, 4 required explantation, whereas only one-managed surgically-achieved successful expander salvage. This case report represents an additive contribution to this literature as the first reported instance of entirely nonsurgical expander salvage in the setting of P. multocida infection. Early microbiological diagnosis, appropriate antibiotic therapy, adjunctive bedside irrigation, and vigilant inpatient monitoring were key elements of this approach. This report highlights a safety-focused conservative management strategy, emphasizing that early-phase infections with low-virulence, beta-lactam-susceptible organisms in immunocompetent patients may not always require immediate explantation in the absence of clinical deterioration. Nonsurgical salvage deserves further investigation as a possible alternative to explantation in carefully selected cases. Level of Evidence: 4 (Therapeutic).