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Pasteurella Multocida Infection Treatment & Management

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

Medical Care

Because P multocida infection is mostly encountered in the setting of an injury following an animal bite, physicians must be familiar with the associated microbiological oral flora of certain animals, especially dogs and cats.

Most animal bites are polymicrobial, with both aerobic and anaerobic bacteria. Several species can be isolated at once.

Several Pasteurella species are associated with dog and cat bites, including P multocida subspecies multocida,P multocida subspecies septica, Pasteurella stomatis, and Pasteurelladogmatis. Pasteurella canis is associated only with dog bites.

Other fastidious gram-negative organisms that have been associated with dog and cat bites include Capnocytophaga canimorsus and Capnocytophaga cynodegmi, especially in patients who had undergone previous splenectomy. C canimorsus infection can cause fulminant sepsis and meningitis, whereas C cynodegmi infection usually causes a milder localized inflammation.

Several other organisms are associated with cat bites, including Bartonella henselae, Francisella tularensis, and cowpox virus.

Medical management of animal bite wounds includes local wound care, standard-protocol tetanus prophylaxis, standard-protocol rabies prophylaxis, and either oral or intravenous empiric antimicrobial treatment.

Antimicrobial treatment is discussed in Medication.

Local care of bite wounds includes cleansing and removing nonviable tissue. Gently cleanse the skin surrounding the bite wound with an antiseptic solution. To prevent further tissue injury, do not scrub the wound directly. Soaking is of no benefit, but copious irrigation with a small-gauge catheter on a syringe helps remove debris and decreases the concentration of bacteria in contaminated wounds. Debridement and closure are discussed in Surgical Care.

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Surgical Care

The initial assessment of an animal bite includes an estimation of the infection risk. Bites to the head and neck, to the distal extremities, and near joints carry the highest risk of infection. In general, persons with animal bite wounds are at a high risk for infection, especially those who present to medical attention more than 8-10 hours after the injury occurred.

Persons with underlying medical diseases, such as diabetes mellitus, chronic liver disease, asplenia, alcoholism, HIV infection, or other immunodeficiency conditions (including chronic steroid exposure), are at increased risk of infection.

After irrigation and cleansing, sharply débride nonviable tissue to reduce the risk of infection and to allow easier suturing by providing a more even edge.

Primary suturing of bite wounds is reserved for minor injuries, those at low risk for infection, and those that have been treated within 8-10 hours of injury.

Leave all other wounds open until the risk of infection is reduced by cleansing, debridement, and prophylactic antibiotics.

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Consultations

See the list below:

  • General surgeon
  • Orthopedic surgeon
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Activity

Elevation is of great importance in the management of limb injuries. Lack of elevation may result in excessive edema, which may produce compartment syndrome and compromise local circulation, to the extent of threatening the viability of the limb.

Wounds on extremities should be immobilized and elevated with a sling to reduce edema, which may hamper normal activities.

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Contributor Information and Disclosures
Author

Sara L Cross, MD Assistant Professor, Department of Internal Medicine, Division of Infectious Diseases, Assistant Professor, Department of Medical Education, University of Tennessee Health Science Center College of Medicine

Sara L Cross, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, 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 Health Science Center College of Medicine

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, Southern Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

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

Disclosure: Received salary from Medscape for employment. for: Medscape.

Aaron Glatt, MD Chief Administrative Officer, Executive Vice President, Mercy Medical Center, Catholic Health Services of Long Island

Aaron Glatt, MD is a member of the following medical societies: American College of Chest Physicians, American Association for Physician Leadership, 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, Society for Healthcare Epidemiology of America

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.

Additional Contributors

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, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Acknowledgements

J Robert Cantey, MD 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 Society for Clinical Investigation, American Society for Microbiology, Infectious Diseases Society of America, International Society of Travel Medicine, Musculoskeletal Infection Society, Phi Beta Kappa, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Alexandre Lacasse, MD, MSc Internal Medicine Faculty, Assistant Director, Medicine Clinic, Infectious Disease Consultant, St Mary's Health Center

Alexandre Lacasse, MD, MSc is a member of the following medical societies: American College of Physicians, American Medical Association, Association of Program Directors in Internal Medicine, Infectious Diseases Society of America, and Society for Healthcare Epidemiology of America

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.

References
  1. Heydemann J, Heydemann JS, Antony S. Acute infection of a total knee arthroplasty caused by Pasteurella multocida: a case report and a comprehensive review of the literature in the last 10 years. Int J Infect Dis. 2010 Sep. 14 Suppl 3:e242-5. [Medline].

  2. Oehler RL, Velez AP, Mizrachi M, Lamarche J, Gompf S. Bite-related and septic syndromes caused by cats and dogs. Lancet Infect Dis. 2009 Jul. 9(7):439-47. [Medline].

  3. Harris PJ, Osswald MB. Pasteurella multocida epiglottitis: A review and report of a new case with associated chronic lymphocytic leukemia. Ear Nose Throat J. 2010 Dec. 89(12):E4. [Medline].

  4. Dryden MS, Dalgliesh D. Pasteurella multocida from a dog causing Ludwig's angina. Lancet. 1996 Jan 13. 347(8994):123. [Medline].

  5. Goussard P, Gie RP, Steyn F, Rossouw GJ, Kling S. Pasteurella multocida lung and liver abscess in an immune-competent child. Pediatr Pulmonol. 2006 Mar. 41(3):275-8. [Medline].

  6. Kagihara JM, Brahmbhatt NM, Paladino J. A fatal pasteurella empyema. Lancet. 2014 Aug 2. 384(9941):468. [Medline].

  7. Mikaberidz N, Li EY, Taub CC. Pasteurella multocida infective endocarditis in an immunocompetent patient complicated by rhabdomyolysis and permanent hearing loss. J Cardiovasc Dis Res. 2013 Mar. 4(1):55-7. [Medline]. [Full Text].

  8. Nettles RE, Sexton DJ. Pasteurella multocida prosthetic valve endocarditis: case report and review. Clin Infect Dis. 1997 Oct. 25(4):920-1. [Medline].

  9. Koelemay MJ. Pasteurella multocida infection, a rare cause of mycotic abdominal aortic aneurysm. J Vasc Surg. 2009 Dec. 50(6):1496-8. [Medline].

  10. Schneider JR, White GW, Dejesus EF. Pasteurella multocida-infected expanded polytetrafluoroethylene hemodialysis access graft. Ann Vasc Surg. 2012 Nov. 26(8):1128.e15-7. [Medline].

  11. Adler AC, Cestero C, Brown RB. Septic shock from Pasturella multocida following a cat bite: case report and review of literature. Conn Med. 2011 Nov-Dec. 75(10):603-5. [Medline].

  12. Fukuchi T, Morisawa Y. [A case of cat-scratch-induced Pasteurella multocida infection presenting with disseminated intravascular coagulation and acute renal failure]. Kansenshogaku Zasshi. 2009 Sep. 83(5):557-60. [Medline].

  13. Green BT, Ramsey KM, Nolan PE. Pasteurella multocida meningitis: case report and review of the last 11 y. Scand J Infect Dis. 2002. 34(3):213-7. [Medline].

  14. Per H, Kumandas S, Gümüs H, Oztürk MK, Coskun A. Meningitis and subgaleal, subdural, epidural empyema due to Pasteurella multocida. J Emerg Med. 2010 Jul. 39(1):35-8. [Medline].

  15. Wade T, Booy R, Teare EL, et al. Pasteurella multocida meningitis in infancy - (a lick may be as bad as a bite). Eur J Pediatr. 1999 Nov. 158(11):875-8. [Medline].

  16. Antony SJ, Oglesby KA. Peritonitis associated with Pasteurella multocida in peritoneal dialysis patients--case report and review of the literature. Clin Nephrol. 2007 Jul. 68(1):52-6. [Medline].

  17. Hutcheson KA, Magbalon M. Periocular abscess and cellulitis from Pasteurella multocida in a healthy child. Am J Ophthalmol. 1999 Oct. 128(4):514-5. [Medline].

  18. Blanco JF, Pescador D, Martín JM, Cano C, Sánchez MD. Acute infection of total knee arthroplasty due to a cat scratch in a patient with rheumatoid arthritis. J Clin Rheumatol. 2012 Sep. 18(6):314-5. [Medline].

  19. Myers EM, Ward SL, Myers JP. Life-threatening respiratory pasteurellosis associated with palliative pet care. Clin Infect Dis. 2012 Mar. 54(6):e55-7. [Medline].

  20. Tattevin P, Souala F, Gautier AL, et al. Diabetes in patients with pasteurellosis. Scand J Infect Dis. 2005. 37(10):731-3. [Medline].

  21. Brivet F, Guibert M, Barthelemy P, et al. Pasteurella multocida sepsis after hemorrhagic shock in a cirrhotic patient: possible role of endoscopic procedures and gastrointestinal translocation. Clin Infect Dis. 1994 May. 18(5):842-3. [Medline].

  22. Rollof J, Johansson PJ, Holst E. Severe Pasteurella multocida infections in pregnant women. Scand J Infect Dis. 1992. 24(4):453-6. [Medline].

  23. Waldor M, Roberts D, Kazanjian P. In utero infection due to Pasteurella multocida in the first trimester of pregnancy: case report and review. Clin Infect Dis. 1992 Feb. 14(2):497-500. [Medline].

  24. Waghorn DJ, Robson M. Occupational risk of Pasteurella multocida septicaemia and premature labour in a pregnant vet. BJOG. 2003 Aug. 110(8):780-1. [Medline].

  25. Baud D, Bizzini A, Jaton K, Achtari C, Prod'hom G, Greub G. Pasteurella multocida Zoonotic Ascending Infection: An Unusual Cause of Tubo-Ovarian Abscess. Vector Borne Zoonotic Dis. 2011 Sep 16. [Medline].

  26. American Academy of Pediatrics. Bite Wounds. Red Book 2012 - Report of the Committee on Infectious Diseases. 29th ed. Elk Grove Village, Ill: American Academy of Pediatrics; 2012. 203-6.

  27. Champlin FR, Shryock TR, Patterson CE, et al. Prevalence of a novel capsule-associated lipoprotein among pasteurellaceae pathogenic in animals. Curr Microbiol. 2002 Apr. 44(4):297-301. [Medline].

  28. Chang K, Siu LK, Chen YH, et al. Fatal Pasteurella multocida septicemia and necrotizing fasciitis related with wound licked by a domestic dog. Scand J Infect Dis. 2007. 39(2):167-70. [Medline].

  29. Citron DM, Warren YA, Fernandez HT, et al. Broth microdilution and disk diffusion tests for susceptibility testing of Pasteurella species isolated from human clinical specimens. J Clin Microbiol. 2005 May. 43(5):2485-8. [Medline].

  30. Clark RB, Joyce SE. Activity of meropenem and other antimicrobial agents against uncommon gram-negative organisms. J Antimicrob Chemother. 1993 Aug. 32(2):233-7. [Medline].

  31. Fajfar-Whetstone CJ, Coleman L, Biggs DR, Fox BC. Pasteurella multocida septicemia and subsequent Pasteurella dagmatis septicemia in a diabetic patient. J Clin Microbiol. 1995 Jan. 33(1):202-4. [Medline].

  32. Goldstein EJ, Citron DM. Comparative activities of cefuroxime, amoxicillin-clavulanic acid, ciprofloxacin, enoxacin, and ofloxacin against aerobic and anaerobic bacteria isolated from bite wounds. Antimicrob Agents Chemother. 1988 Aug. 32(8):1143-8. [Medline].

  33. Goldstein EJ, Citron DM, Merriam CV, et al. Activity of gatifloxacin compared to those of five other quinolones versus aerobic and anaerobic isolates from skin and soft tissue samples of human and animal bite wound infections. Antimicrob Agents Chemother. 1999 Jun. 43(6):1475-9. [Medline].

  34. Goldstein EJ, Citron DM, Merriam CV, et al. Comparative in vitro activities of GAR-936 against aerobic and anaerobic animal and human bite wound pathogens. Antimicrob Agents Chemother. 2000 Oct. 44(10):2747-51. [Medline].

  35. Goldstein EJ, Citron DM, Merriam CV, Warren YA, Tyrrell KL, Fernandez HT. Comparative in vitro activity of faropenem and 11 other antimicrobial agents against 405 aerobic and anaerobic pathogens isolated from skin and soft tissue infections from animal and human bites. J Antimicrob Chemother. 2002 Sep. 50(3):411-20. [Medline].

  36. Goldstein EJ, Citron DM, Richwald GA. Lack of in vitro efficacy of oral forms of certain cephalosporins, erythromycin, and oxacillin against Pasteurella multocida. Antimicrob Agents Chemother. 1988 Feb. 32(2):213-5. [Medline].

  37. Griego RD, Rosen T, Orengo IF, et al. Dog, cat, and human bites: a review. J Am Acad Dermatol. 1995 Dec. 33(6):1019-29. [Medline].

  38. Hey P, Gow P, Torresi J, Testro A. Cirrhosis, cellulitis and cats: a 'purrfect' combination for life-threatening spontaneous bacterial peritonitis from Pasteurella multocida. BMJ Case Rep. 2012 Nov 11. 2012:[Medline].

  39. Kimura R, Hayashi Y, Takeuchi T, et al. Pasteurella multocida septicemia caused by close contact with a domestic cat: case report and literature review. J Infect Chemother. 2004 Aug. 10(4):250-2. [Medline].

  40. Kravetz JD, Federman DG. Cat-associated zoonoses. Arch Intern Med. 2002 Sep 23. 162(17):1945-52. [Medline].

  41. Lion C, Conroy MC, Carpentier AM, et al. Antimicrobial susceptibilities of Pasteurella strains isolated from humans. Int J Antimicrob Agents. 2006 Apr. 27(4):290-3. [Medline].

  42. Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000. 2404-7.

  43. Meha H, Mackle I. Prosthetic joint infection with Pasteurella multocida following cat scratch: a report of 2 cases. J Arthroplasty. Jun 2004. 19(4):525-7.

  44. Murphy E. Microbiology of animal bites. Clinical Microbiology Newsletter. Apr 2008. 30(7):47-50.

  45. Raval P, Khan W, Haddad B, Mahapatra AN. Bite injuries to the hand - review of the literature. Open Orthop J. 2014. 8:204-8. [Medline]. [Full Text].

  46. Rosenau A, Labigne A, Escande F, et al. Plasmid-mediated ROB-1 beta-lactamase in Pasteurella multocida from a human specimen. Antimicrob Agents Chemother. 1991 Nov. 35(11):2419-22. [Medline].

  47. Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014 Jul 15. 59(2):e10-52. [Medline].

  48. Weber DJ, Wolfson JS, Swartz MN, et al. Pasteurella multocida infections. Report of 34 cases and review of the literature. Medicine (Baltimore). 1984 May. 63(3):133-54. [Medline].

 
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