Pasteurella multocida infection of a total hip arthroplasty. A case report

The authors report a case history of a diabetic woman requiring revision hip arthroplasty of a Charnley total hip prosthesis that was infected with Pasteurella multocida. The infection of the loose prosthesis followed a cat bite to the same leg. Advice is given on the management of patients with infection following animal inoculations, and the subject of increased risk with a loose prosthesis is discussed.

Pasteurella infection in a total knee arthroplasty

Hematogenous infection of a total joint arthroplasty is a serious complication that has well-known etiologies. One of the most unusual inciting events is a bite wound. Pasteurella multocida is an anaerobic organism found in the mouths of mammals that has rarely been found to infect total knee arthroplasties. Prompt recognition of such an infection and prophylactic treatment with a penicillinase-resistant penicillin should maximize the patient's opportunity to eradicate such an infection.

Pasteurella multocida empyema: successful treatment with open thoracostomy

Pasteurella multocida appears to be an uncommon pathogen in human thoracic empyema. The morbidity and mortality associated with these infections has been significant, presumably secondary to the elderly populations they affect, many with chronic lung disease and impaired pulmonary defenses. We report a case of pasteurella empyema treated with open thoracostomy and rib resection and advocate use of such a procedure early in the treatment of patients with this infection.

The effect of venous blood stream cooling on survival of bacterially infected rabbits

The effect of physical cooling on the mortality rate of rabbits infected with Pasteurella multocida was investigated. Rabbits were cooled for 48 hours after bacterial injection by passing cold fluid through small hollow metal cuffs which had been surgically implanted around the abdominal vena cavae of rabbits. The average body temperatures of the rabbits during the 24-hour period after the intravenous injection of live Pasteurella multocida was 40.92 +/- 0.20 degrees C in control rabbits and 38.98 +/- 0.71 degrees C in cooled rabbits. 90% of physically cooled rabbits survived compared with 46% of control rabbits 48 hours after bacterial injection, suggesting that thermoregulatory effector mechanisms involved in cold defense may enhance survival.

Use of recombinant bovine alpha 1 interferon in reducing respiratory disease induced by bovine herpesvirus type 1

Intranasal or intramuscular treatment of calves with recombinant bovine alpha 1 interferon before challenge with bovine herpesvirus type 1 and Pasteurella haemolytica reduced clinical signs, number of sick days, lung lesions, and weight loss. The effective dose was determined to be relatively broad within the range of 1 to 50 mg per animal. No adverse effects were observed even at high doses of interferon (50 mg per animal). Administration before virus infection was more effective than administration at the same time as virus infection. Although interferon administration had dramatic effects on the survival of animals, it did not have much effect on virus secretion in the upper respiratory tract. Therefore, the mechanism by which interferon reduces the susceptibility of animals to viral-bacterial synergy was postulated to be via its immunomodulatory effects.

Osteomyelitis of the heel with Pasteurella pneumotropica: a case report

A rare case of Pasteurella pneumotropica occurring in a polymicrobial anaerobic osteomyelitis of the heel is presented. The natural history, predisposing conditions, treatment, and postoperative care are presented. Surgical excision of the infected portion of the calcaneus, appropriate antibiotics, and lift with proper supporting heel cup all aided in returning the patient to her normal daily activities.

Pasteurella infections of the head and neck

Infections caused by Pasteurella occur most frequently after domestic animal bites or scratches and in individuals with agricultural or veterinary contact with animals. A serious Pasteurella infection developed in an agricultural worker following tumor extirpation of a head and neck neoplasm. Review of Pasteurella infections in humans disclosed that 31 of 446 reported infections involved head and neck structures. The most serious of these involved the adjacent central nervous system. Surgical drainage combined with parenteral penicillin remains the treatment of choice in these infections. Aminoglycosides are not effective in treating this organism.

Effect of bovine alpha 1 interferon on bovine herpesvirus type 1-induced respiratory disease

Treatment of calves with bovine recombinant alpha 1 interferon prior to challenge with bovine herpesvirus type 1 increased the animals' ability to withstand a subsequent Pasteurella haemolytica challenge. The reduction in viral-bacterial synergy observed following interferon treatment did not appear to be due to a direct effect of the interferon on virus replication in the upper respiratory tract. Thus, even though interferon-treated animals shed slightly less virus from their nasal passages than did untreated animals, this reduction was not statistically significant. Furthermore, there was no difference in the level of intranasal interferon secreted by control or interferon-treated animals. These results suggest that interferon treatment does not affect the production of endogenous interferon. In contrast, a significant difference was observed between the number of days that control animals were sick, the levels of serum fibrinogen and the functional activity of polymorphonuclear neutrophilic granulocytes obtained from infected calves. These results suggest that bovine recombinant alpha 1 interferon may have a greater immunomodulatory effect than a direct antiviral effect in this model. This is further supported by the observation that bovine herpesvirus type 1 is relatively resistant to the direct antiviral effect of bovine recombinant alpha 1 interferon in vitro.

Hematogenous Pasteurella multocida brain abscess

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Pasteurella multocida infections. Report of 34 cases and review of the literature

Pasteurella multocida, a small, gram-negative coccobacillus , is part of the normal oral flora of many animals, including the dog and cat. P. multocida is the etiologic agent in a variety of infectious disease syndromes. We have reported 34 cases of infection caused by P. multocida and have reviewed the English literature. P. multocida infections may be divided into three broad groups: 1. Infections resulting from animal bites and scratches : The most common infections caused by P. multocida are local wound infections following animal bites or scratches . Cats are the source of infection in 60 to 80% of cases and dogs in the great majority of the remainder. Local infections are characterized by the rapid appearance of erythema, warmth, tenderness, and frequently purulent drainage. The most common local complications are abscess formation and tenosynovitis. Serious local complications include septic arthritis proximal to bites or scratches , osteomyelitis resulting from direct inoculation or extension of cellulitis, and the combination of septic arthritis and osteomyelitis, most commonly involving a finger or hand after a cat bite. 2. Isolation of P. multocida from the respiratory tract: The isolation of P. multocida from the respiratory tract must be interpreted differently than its isolation from other systemic sites. Most commonly P. multocida found in the respiratory tract is a commensal organism in patients with underlying pulmonary disease, but serious respiratory tract infections including pneumonia, empyema, and lung abscesses may develop. Most patients with respiratory tract colonization or infection have a history of animal exposure. 3. Other systemic infections: P. multocida is recognized as a pathogen in a variety of systemic infections including bacteremia, meningitis, brain abscess, spontaneous bacterial peritonitis, and intra-abdominal abscess. P. multocida often acts as an opportunistic pathogen with a predilection for causing bacteremia in patients with liver dysfunction, septic arthritis in damaged joints, meningitis in the very young or elderly, and pulmonary colonization or invasion in patients with underlying respiratory tract abnormalities.(ABSTRACT TRUNCATED AT 400 WORDS)

A field trial, of preshipment vaccination, with intranasal infectious bovine rhinotracheitis-parainfluenza-3 vaccines

A total of 849 calves, 278 controls, 335 vaccinated intranasally with IBR-PI3/TS and 236 vaccinated intranasally with IBR-PI3/PTC were studied in a field trial of preimmunization. All calves were vaccinated in Saskatchewan at least three weeks prior to shipment to feedlots. Four hundred and twenty six calves were not sold within eight weeks of vaccination; however, seven of these died within four weeks of vaccination. Treatment rates varied from 1.0% to 5.2%. There was no significant effect of vaccination on treatment rates. Similarly, there was no significant effect of vaccination in the 74 calves sold to feedlots in Saskatchewan. Three hundred and forty nine calves were sold to feedlots in Ontario. Two of these died from fibrinous pneumonia. Treatment rates varied from 1.7% to 33.3% in different feedlots, but there was no significant effect of vaccination on treatment rates. Therefore, preimmunization is unlikely to significantly reduce the overall treatment rate in calves entering feedlots.

Pasteurella multocida osteomyelitis caused by cat bite

A previously healthy 15-year-old girl was bitten by a cat in her left thumb. Despite initial treatment with penicillin she developed osteomyelitis after a period of four months. Pasteurella multocida was cultured from the necrotic bone. The infection showed low activity and was successfully treated with surgery combined with penicillin.

Pasteurella multocida--the major cause of hand infections following domestic animal bites

Pasteurella multocida is a common cause of infection following bites or scratches caused by dogs and (especially) cats. It is rarely reported, however, and apparently often overlooked as a pathogen. The typical clinical manifestation is a rapidly developing cellulitis at the site of injury. The infection is potentially dangerous and can cause a chronic local infection of deep tissues and osteomyelitis. It responds well to several antimicrobials, with penicillin being drug of choice. Fifty-five patients are reported--72% with cat bites and/or scratches and 28% with dog bites. Ninety-two percent of the wounds went deeply through the skin. All patients presented for treatment 12 to 72 hours after receiving the animal wounds to their hands. Drainage from all wounds was serosanguineous or purulent, and cultures taken were positive for P. multocida. All of the wounds responded to surgical drainage and penicillin. One patient developed osteomyelitis. The acute onset of cellulitis, lymphangitis, and serosanguineous or purulent drainage from hand wounds 12 to 24 hours after cat or dog bites should suggest P. multocida as the predominant etiologic agent. Immediate surgical drainage and penicillin therapy is the treatment of choice.

Pasteurella multocida subdural empyema: a case report

The first case of Pasteurella Multocida subdural empyema is reported. This was secondary to hematogenous spread from the pharynx to a chronic subdural hematoma. Positive cultures were obtained from the primary source, the blood and the subdural space. The patient was discharged with no neurological deficit following surgical drainage and parenteral antibiotics. The incidence, predisposing factors, clinical features, bacteriology, diagnostic procedures, treatment and mortality of subdural empyema are briefly discussed.

Pasteurella multocida empyema: case report and review of the literature

A case report and review of 13 cases of Pasteurella multocida empyema in the English literature demonstrate the apparent increased pathogenicity of this organism in patients with chronic lung disease. The infections were marked by their indolence, minimal febrility, blood-tinged pleural fluid, and predilection for the elderly. The was no characteristic roentgenographic pattern. Animal exposure commonly preceded the illnesses. It is postulated that the disease occurs in patients with impaired pulmonary defenses who acquire the organism via the inhalation of infectious droplets aerosolized from the oropharynx of animals where P multocida is part of the normal flora. Although most isolates were penicillin sensitive, there was significant mortality.

Pasteurella multocida infection in the hand

We have discussed 13 patients with Pasteurella multocida infection of the hand, six of whom developed chronic hand impairment as a result of the infection. It is thus apparent that chronic morbidity following Pasteurella infection of the hand is nearly 50 percent. Despite a fairly wide antibiotic susceptibility pattern of this organism, the infection may have long-term consequences such as osteomyelitis, or small joint stiffness due to paraarticular infection. We wish to emphasize the rapid evolution of the clinical picture following inoculation and the need for vigorous antibiotic therapy supplemented by rest, elevation immobilization, and occasional surgical decompression or drainage. At this time, the preferred antibiotic for initial care would appear to be on of the cephalosporins changed to penicillin for the culture-proven infection.

Human pulmonary pasteurellosis

Pasteurella multocida causes hemorrhagic septicemia in many domestic and wild animals. The most common human infection with P multocida is a local cellulitis following animal-inflicted wounds, preponderantly cat bites and scractches. The typical clinical manifestations and complications have been well described previously. We present three cases of pulmonary pasteurellosis that were recently evaluated by the infectious diseases service at Barnes Hospital. In three additional cases, the technologists in the microbiology laboratory isolated P multocida from respiratory tract secretions.