eMedicine Specialties > Infectious Diseases > Bacterial Infections

Pasteurella Multocida Infection: Differential Diagnoses & Workup

Author: Alexandre Lacasse, MD, MSc, Fellow in Infectious Diseases, University of Tennessee at Memphis
Coauthor(s): Michael Gelfand, MD, FACP, Chief, Professor, Department of Internal Medicine, Division of Infectious Diseases, Methodist Healthcare of Memphis, University of Tennessee; Thomas Lafeber, MD, Consulting Staff, Wellstar Infectious Disease LLC; J Robert Cantey, MD, Chief of Infectious Disease, Veterans Affairs Medical Center, Director, Professor, Department of Medicine, Division of Infectious Diseases, Medical University of South Carolina
Contributor Information and Disclosures

Updated: Jan 21, 2009

Differential Diagnoses

Abdominal Abscess
Liver Abscess
Amebic Hepatic Abscesses
Lung Abscess
Animal Bites
Meningitis
Brain Abscess
Meningococcal Infections
Catscratch Disease
Perinephric Abscess
Cellulitis
Pneumonia, Bacterial
HACEK Group Infections
Pneumonia, Community-Acquired
Haemophilus Influenzae Infections
Pyelonephritis, Acute
Intra-abdominal Sepsis

Other Problems to Be Considered

Infective endocarditis
Osteomyelitis
Septic arthritis
Necrotizing fasciitis
Tenosynovitis
Catheter-associated bloodstream infections
Spontaneous bacterial peritonitis
Peritoneal dialysis catheter-associated peritonitis

Workup

Laboratory Studies

  • Gram stain of purulent material or other fluid specimens including blood, sputum, and cerebrospinal fluid may show small, gram-negative, nonmotile, non–spore-forming pleomorphic coccobacilli.
  • Haemophilus species, N meningitides, Moraxella species, and Acinetobacter species have a morphology that is similar to that of P multocida infection and can therefore be easily confused with Pasteurella species .
  • Wright, Giemsa, and Wayson stains enhance bipolar staining. Some P multocida strains exhibit a mucous capsule.
  • Pasteurella species are highly sensitive to several penicillins and cephalosporins. Susceptibility testing is indicated in immunocompromised patients and in the setting of treatment failure or drug allergies.

Imaging Studies

  • CT scanning and/or MRI: Evaluation of tenosynovitis, septic arthritis, osteomyelitis, and meningeal enhancement, when appropriate
  • Echocardiography: Evaluation of suspected endocarditis

Procedures

  • Deep soft-tissue P multocida infections require debridement at times. Intraoperative cultures should be taken at time of surgery.
  • Lumbar puncture should be performed if meningitis is suspected.
  • Arthrocentesis should be performed if septic arthritis is suspected.
  • Abdominal paracentesis is required in patients with ascites to assess the possibility of spontaneous bacterial peritonitis, especially in those with significant clinical liver disease with a history of pet exposure.

Histologic Findings

  • When available, infected tissue has features consistent with an acute purulent inflammation with neutrophilic predominance and possibly necrosis.

More on Pasteurella Multocida Infection

Overview: Pasteurella Multocida Infection
Differential Diagnoses & Workup: Pasteurella Multocida Infection
Treatment & Medication: Pasteurella Multocida Infection
Follow-up: Pasteurella Multocida Infection
Multimedia: Pasteurella Multocida Infection
References
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References

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Further Reading

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Keywords

Pasteurella multocida infection, P multocida infection, pasteurellosis, coccobacillus, coccobacilli, bacterial infection, dog bite, cat bite, cat scratch, bite wound, animal bite wound, cat lick, pet wound, pet bite, meningitis, tetanus, rabies

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Contributor Information and Disclosures

Author

Alexandre Lacasse, MD, MSc, Fellow in Infectious Diseases, University of Tennessee at Memphis
Alexandre Lacasse, MD, MSc is a member of the following medical societies: American College of Physicians, American Medical Association, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Coauthor(s)

Michael Gelfand, MD, FACP, Chief, Professor, Department of Internal Medicine, Division of Infectious Diseases, Methodist Healthcare of Memphis, University of Tennessee
Michael Gelfand, MD, FACP is a member of the following medical societies: American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, and Southern Medical Association
Disclosure: Nothing to disclose.

Thomas Lafeber, MD, Consulting Staff, Wellstar Infectious Disease LLC
Thomas Lafeber, MD is a member of the following medical societies: American Medical Association, American Society of Transplantation, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

J Robert Cantey, MD, Chief of Infectious Disease, Veterans Affairs Medical Center, Director, Professor, Department of Medicine, Division of Infectious Diseases, Medical University of South Carolina
J Robert Cantey, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Society for Clinical Investigation, American Society for MOHS Surgery, Infectious Diseases Society of America, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Medical Editor

Larry I Lutwick, MD, Professor of Medicine, State University of New York, Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus
Larry I Lutwick, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Aaron Glatt, MD, Professor of Clinical Medicine, New York Medical College; President and CEO, Former Chief Medical Officer, Departments of Medicine and Infectious Diseases, New Island Hospital
Aaron Glatt, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physician Executives, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Medical Association, American Society for Microbiology, American Thoracic Society, American Venereal Disease Association, Infectious Diseases Society of America, International AIDS Society, and Society for Healthcare Epidemiology of America
Disclosure: Nothing to disclose.

CME Editor

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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