Moraxella Catarrhalis Infections Clinical Presentation

  • Author: Michael Constantinescu, MD; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Sep 26, 2011
 

History

  • Common cold: In 29% of common-cold episodes due to bacterial pathogens (including M catarrhalis), affected children continued to be symptomatic 10 days after the first appearance of symptoms.[2]
  • Otitis media: A clinical history of acute otitis media and otitis media with effusion with symptoms includes otalgia, fever, and hearing loss. Otitis media is a very common condition, especially in children. Approximately 70% of children have at least one episode of otitis media during childhood. M catarrhalis has been isolated in 3%-17.3% of middle ear exudates in children with otitis media.[3, 4]
  • Sinusitis: Clinical history commonly includes headache, pain in the maxillary or frontal area, fever, and cough. Young children present with persistent nasal discharge (lasting >2 wk) and cough, especially at night. M catarrhalis has been isolated in 22% of maxillary sinus aspirates in children as a single pathogen and in 72% of aspirates in combination with other organisms such as S pneumoniae and/or H influenzae.[5]
  • Lower respiratory tract infections
    • Adult patients with a history of conditions such as chronic obstructive pulmonary disease (COPD), pneumoconiosis, asthma, malignancies, or immunosuppression, with findings characteristic of bronchitis or pneumonia or exacerbations of their underlying condition, may have an M catarrhalis infection. Lower respiratory tract infections with M catarrhalis were also associated with smoking in 77% of patients in a meta-analysis. M catarrhalis was isolated from sputum and transtracheal aspirate specimens at rates of 0.2%-8.1%. In more than 30% of cases, H influenzae and/or S pneumoniae was isolated in addition to M catarrhalis.[6, 7, 8, 9]
    • In children, lower respiratory tract infections have been associated with a history of recent respiratory syncytial virus or cytomegalovirus infection or with more debilitating conditions such as bronchopulmonary dysplasia, ventricular septal defect, leukemia, Arnold-Chiari syndrome, prematurity, or HIV infection.[10, 11]
  • Nosocomial infections: Outbreaks of infections with M catarrhalis have been reported, mostly involving pulmonary units or pediatric intensive care units.
  • Bacteremia: No primary site of infection was found in 46% of patients with M catarrhalis bacteremia. Bacteremia is rare with M catarrhaliscommunity-acquired pneumonia.[12] The following conditions have been found to predispose to M catarrhalis bacteremia:
  • Endocarditis: M catarrhalis endocarditis has been described in patients with previous history of valvular conditions or prosthesis, as well as in patients who were previously healthy. It has also been described as a complication of balloon angioplasty.[13, 14]
  • Pathogen in cleft palate repairs (resulting in higher fistula rate)[15]
  • Sporadic cases of other infections with M catarrhalis include the following:
    • Meningitis
    • Neonatal ophthalmia
    • Septic arthritis
    • Keratitis
    • Urinary tract infection
    • Wound infection
    • Peritonitis in patients on dialysis
    • Conjunctivitis
    • Periorbital cellulitis[16]
    • Acute urethritis resembling gonorrhea[17]
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Physical

Physical findings in M catarrhalis infections are similar to findings of infections with other organisms in the same location.

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Contributor Information and Disclosures
Author

Michael Constantinescu, MD  Staff Pathologist, Overton Brooks Veterans Affairs Medical Center

Michael Constantinescu, MD is a member of the following medical societies: American Society for Clinical Pathology, College of American Pathologists, and United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.

Coauthor(s)

Joseph A Bocchini Jr, MD  Medical Director of Children's Hospital; Chief of Infectious Disease Section, Director of Clinical Virology Laboratory, Chairman, Professor, Department of Pediatrics, Louisiana State University School of Medicine in Shreveport

Joseph A Bocchini Jr, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, and Southern Society for Pediatric Research

Disclosure: Nothing to disclose.

Ronald Silberman, PhD  Director of Clinical Microbiology Laboratory, Louisiana State University Hospital; Professor, Department of Pathology, Louisiana State University Medical Center at Shreveport

Disclosure: Nothing to disclose.

James D Cotelingam, MBBS, MD  Head of Hematopathology, Director of Clinical Laboratories, Professor, Department of Pathology, Louisiana State University at Shreveport

James D Cotelingam, MBBS, MD is a member of the following medical societies: American College of Physician Executives, American Society for Clinical Pathology, Association of Military Surgeons of the US, College of American Pathologists, and New York Academy of Sciences

Disclosure: Nothing to disclose.

Specialty Editor Board

Maria D Mileno, MD  Associate Professor of Medicine, Division of Infectious Diseases, The Warren Alpert Medical School of Brown University

Maria D Mileno, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, International Society of Travel Medicine, and Sigma Xi

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Joseph F John Jr, MD, FACP, FIDSA, FSHEA  Clinical Professor of Medicine, Molecular Genetics and Microbiology, Medical University of South Carolina College of Medicine; Associate Chief of Staff for Education, Ralph H Johnson Veterans Affairs Medical Center

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

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