The patient described was immunologically compromised by multisystem trauma. Pasteurella multocida was isolated from the respiratory tract and subsequently from the cerebrospinal fluid; direct spread apparently occurred by way of a basilar skull fracture. Sepsis was absent. He was successfully treated but subsequently had hydrocephalus, which has not previously been reported to occur after P multocida meningitis. Because of the opportunistic nature of this infrequent human commensal and the significant morbidity and mortality associated with it, we believe that isolation of Pasteurella multocida from the respiratory tract justifies treatment, especially in the compromised host.