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Moraxella catarrhalis Infection Clinical Presentation

  • Author: Michael Constantinescu, MD; Chief Editor: Michael Stuart Bronze, MD  more...
Updated: Oct 06, 2015

History and Physical Examination

The history typically suggests the type of infection present (eg, upper respiratory tract infection [URTI], lower respiratory tract infection [LRTI], bacteremia, or endocarditis). Physical findings in M catarrhalis infections are similar to findings of infections with other organisms in the same location.

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.[3]

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 experience at least 1 episode of otitis media during childhood. M catarrhalis has been isolated in 3-17.3% of middle ear exudates in children with otitis media.[4, 5]


In a patient with sinusitis, the clinical history commonly includes headache, pain in the maxillary or frontal area, fever, and cough. Young children present with persistent nasal discharge (lasting longer than 2 weeks) 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 (eg, S pneumoniae or H influenzae).[6]

Lower respiratory tract infection

In adult patients who have a history of conditions such as chronic obstructive pulmonary disease (COPD), pneumoconiosis, asthma, malignancies, or immunosuppression and who show findings characteristic of bronchitis or pneumonia or exacerbations of their underlying condition, M catarrhalis infection is a possibility. M catarrhalis LRTI is also associated with smoking. M catarrhalis is isolated from sputum and transtracheal aspirate specimens at rates of 0.2-8.1%, accompanied by H influenzae and/or S pneumoniae in more than 30% of cases.[7, 8, 9, 10]

In children, LRTIs 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.[11, 12]

Nosocomial infections

Outbreaks of nosocomial infections with M catarrhalis have been reported, mostly involving pulmonary units or pediatric intensive care units (PICUs).


In 46% of patients with M catarrhalis bacteremia, no primary site of infection is found. Bacteremia is rare with M catarrhaliscommunity-acquired pneumonia.[13] The following conditions have been found to predispose to M catarrhalis bacteremia:

  • Immunodeficiency or chronic respiratory conditions such as COPD, bronchiectasis, or cystic fibrosis [11, 7, 8, 12, 9, 10]
  • Neutropenia, systemic lupus erythematosus, or leukemia

Endocarditis and other local infections

M catarrhalisendocarditis has been described in patients with a history of valvular conditions or prostheses, as well as in patients who were previously healthy. It has also been described as a complication of balloon angioplasty.[14, 15] M catarrhalis has been identified as a pathogen in cleft palate repairs (resulting in a higher fistula rate).[16] 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 [17]
  • Acute urethritis resembling gonorrhea [18]


Complications of M catarrhalis infection may include the following:

  • Recurrence
  • Bacteremia and sepsis
  • Meningitis
  • Mastoiditis
  • Hearing loss
  • Pleural effusion
  • Shock
  • Death
Contributor Information and Disclosures

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, United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.


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

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

Disclosure: Nothing to disclose.

Ronald Silberman, PhD Director of Clinical Microbiology Laboratory, Louisiana State University Hospital; Professor, Department of Pathology, Louisiana State University School of Medicine in Shreveport

Disclosure: Nothing to disclose.

Joseph A Bocchini, Jr, MD Medical Director of Children's Hospital; Member, Pediatric Infectious Disease Section, 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, Southern Society for Pediatric Research

Disclosure: Nothing to disclose.

Chief Editor

Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, Oklahoma State Medical Association, Southern Society for Clinical Investigation, Association of Professors of Medicine, American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.


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.

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

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