PASTEURELLA MULTOCIDA INFECTIONS. A REPORT OF SIX CASES

Bacterial osteomyelitis in adults: evolving considerations in diagnosis and treatment

Bacterial osteomyelitis causes substantial morbidity worldwide, despite continued progress toward understanding its pathophysiology and optimal management. The approach to osteomyelitis depends upon the route by which bacteria gained access to bone, bacterial virulence, local and systemic host immune factors, and patient age. While imaging studies and nonspecific blood tests may suggest the diagnosis, an invasive technique is generally required to identify the causative pathogens. Given the paucity of comparative clinical trials, antibacterial regimen selection has been largely guided by knowledge of the relative activities and pharmacokinetics of individual drugs, supported by data from animal models. Definitive therapy often requires a combined medical and surgical approach. Newer microvascular and distraction osteogenesis techniques and the use of laser doppler allow more complete surgical resection of infected material while maintaining function. Despite recent advances, many patients with osteomyelitis fail aggressive medical and surgical therapy. More accurate diagnostic methods, better ways to assess and monitor the effectiveness of therapy, and novel approaches to eradicate sequestered bacteria are needed.

Pasteurella multocida--an uncommon cause of obstetric and gynaecological sepsis

Pasteurella multocida is a common cause of wound infection following animal-inflicted wounds, but is a rare cause of female genito-urinary sepsis. We present a case of vulval sepsis and a case of intrapartum septicaemia with this bacterium. These two cases indicate that Pasteurella multocida can occasionally colonise the female lower genital tract and this bacterium should be considered in the differential diagnosis of serious infection related to this site.

Recovery of an unusual Flavobacterium group IIb-like isolate from a hand infection following pig bite

An unusual gram-negative rod (RMA 1571) was isolated from a hand infection following a pig bite. This unclassified isolate was characterized by growth requirements, microscopic examination, biochemical characteristics, antimicrobial susceptibility tests, and cellular fatty acid analysis. It was indole positive and produced yellow-pigmented growth, which placed it in the genus Flavobacterium, but its other features, including cellular fatty acid analysis, did not appear to be those of a named species.

Pasteurella multocida bacteremia: report of thirteen cases over twelve years and review of the literature

13 episodes of bacteremia caused by Pasteurella multocida were seen in a general hospital during a 12-year period. All the patients had an underlying disease (77% had cirrhosis) and 2 were receiving chemotherapy for hematologic malignancy. There was a numerical preponderance of male patients (69%). In 5/13 cases a recent animal-derived trauma could be found. In the other cases the source of the infecting organism was thought to be endogenous (from patients' own pharyngeal commensal flora) or secondary to contact with secretions of a pet animal. The clinical presentation of sepsis caused by this organism was nonspecific. Hypotension was seen in 5 cases. Localized sites of infection were certain in 6 and only clinically suspected in 4 other cases. The overall mortality rate was 31%. The administration of ampicillin seems the appropriate therapy for Pasteurella multocida bacteremia.

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 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.

Clostridium pseudotetanicum bacteremia in a patient with Pasteurella multocida conjunctivitis

Clostridium pseudotetanicum only once previously has been identified as causing disease. Pasteurella multocida has been identified only three times as the cause of purulent conjunctivitis. A very debilitated patient had C. pseudotetanicum bacteremia and P. multocida conjunctivitis from which she recovered only to die of a nosocomial Staphylococcus epidermidis septicemia, originating in a site for the administration of intravenous fluids.

Corneal ulcer caused by Pasteurella multocida

A 44-year-old woman with Graves' disease and exophthalmos developed a severe corneal ulcer caused by Pasteurella multocida after being bumped on her right eye by her pet dog. The organism was transferred from the patient to an abraded rabbit cornea and produced a similiar corneal ulcer and hypopyon.

Panophthalmitis due to Pasteurella septica

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