Pasteurella multocida Infections: I. Pasteurella Multocida Infection Due to Animal Bite

LONEPINELLA SP. ISOLATED FROM WOUND INFECTIONS OF KOALAS

We describe two cases of wound infections of koalas (Phascolarctos cinereus), one wild and one captive, in which Lonepinella-like organisms were involved. The wild adult koala was captured with bite wound injuries, as part of a koala population management program in Queensland, Australia. In both cases, there was evidence of physical trauma causing the initial wound. The captive koala suffered injury from the cage wire, and the wild koala had injuries suggestive of intermale fighting. Gram-negative bacteria isolated from both cases proved to be challenging to identify using routine diagnostic tests. The wound in the captive koala yielded a pure culture of an organism shown by whole genome sequence (WGS) analysis to be a member of the genus Lonepinella, but not a member of the only formally described species, L. koalarum. The wound of the wild koala yielded a mixed culture of Citrobacter koseri, Enterobacter cloacae and an organism shown by WGS analysis to be Lonepinella, but again not Lonepinella koalarum. Both cases were difficult to treat; the captive koala eventually had to have the phalanges amputated, and the wild koala required removal of the affected claw. The two Lonepinella isolates from these cases have a close relationship to an isolate from a human wound caused by a koala bite and may represent a novel species within the genus Lonepinella. Wound infections in koalas linked to Lonepinella have not been reported previously. Wildlife veterinarians need to be aware of the potential presence of Lonepinella-like organisms when dealing with wound infections in koalas, and the inability of commercial kits and systems to correctly identify the isolates.

Pasteurella Multocida Panophthalmitis: A Devastating Sequela of an Industrial Penetrating Injury

Pasteurella multocida is a rare but aggressive causative organism in panophthalmitis. It is commonly transmitted to humans through contact with cats and dogs as a result of bites or scratches. We report a rare case of panophthalmitis due to P. multocida following an industrial penetrating injury.

A previously healthy 40-year-old steel factory operator developed a right eye penetrating injury after being struck accidentally by a piece of iron wire which flew into his eye during work. He complained of immediate blurring of vision and severe pain in the affected eye. During history taking, he mentioned that many stray cats wandered around his workplace, although he had no direct contact with these animals. On examination, the best-corrected visual acuity was light perception in the right eye. Slit-lamp biomicroscopy revealed injected conjunctiva and a full-thickness macerated corneal laceration wound. The anterior chamber appeared shallow with the presence of lens matter. He was treated promptly with surgical repair along with intracameral and intravenous antibiotics for six hours post-trauma. His eye condition, however, deteriorated postoperatively despite aggressive treatment with further topical, intravitreal, and systemic antibiotics.

This is the first reported case of ocular P. multocida panophthalmitis secondary to industrial penetrating injury. Our case highlights the rapidly progressive nature of P. multocida infection. It should always be considered due to the very serious nature of infection as well as its resistance to standard antibiotic treatment regimens.

Burden of Bites by Dogs and Other Animals in Los Angeles County, California, 2009-2011

OBJECTIVES

The objective of this study was to analyze all animal-to-human bite reports during a 3-year period from a regional surveillance database. Results helped to inform local efforts to reduce and prevent animal-to-human bites.

METHODS

We reviewed all cases of animal-to-human bites occurring from 2009 through 2011 that were reported to the Los Angeles County Department of Public Health's Animal Bites Database. We collected data on the bite victim's date of birth, age, and address; bite circumstances (ie, date, time, location, how bite occurred); anatomic site and treatment of bite; type of reporting facility; and breed and management of biting animal.

RESULTS

From 2009 through 2011, 26   169 animal-to-human bites were reported, of which 23   103 (88%) were dog bites. Most animal-to-human bites (n = 7673, 29%) occurred between 4 pm and 8 pm and peaked during the month of July (n = 2663, 10%). Most animal-to-human bites occurred outdoors (n = 8772, 34%) and while victims engaged in recreational activities (n = 4353, 17%). The hands were the most common injury site (n = 9130, 35%), and only 1% of animal bites (n = 267) resulted in hospitalization. A total of 4115 bite victims (16%) received tetanus vaccinations. Of all animal-to-human bite cases, medical organizations reported 13   451 (51%), and animal control agencies reported 10   682 (41%).

CONCLUSIONS

Animal-to-human bites can often lead to medical complications. Surveillance is essential in helping to identify, manage, and reduce these highly preventable injuries and direct public health actions and policies on animal bite risk and prevention.

Risk factors for invasive pasteurellosis: a retrospective case study

Pasteurellosis is a frequent zoonosis mainly transmitted by cats and dogs. Invasive forms of pasteurellosis are associated with significant morbidity and mortality. This retrospective study aimed to highlight risk factors (RFs) for invasive pasteurellosis. We included patients with positive Pasteurella samples. The clinical forms were classified as invasive or local pasteurellosis. We evaluated 13 RFs: age, sex, alcohol use, tobacco use, chronic liver disease, chronic renal failure, diabetes, chronic cardiovascular disease, chronic pulmonary disease, chronic inflammatory disease, chronic osteoarticular disease, immunosuppression, and progressive cancers. One hundred and two patients were enrolled; 28 and 74 had invasive and local forms respectively. Invasive forms included eight isolated bacteraemia, one septic shock, seven large-joint arthritis, two neurological infections, two abdominal infections, and eight pulmonary pasteurellosis. The mortality rate was 4 %, including 11 % and 1.4 % of patients with invasive or localized disease respectively. RFs statistically associated with the invasive group vs the local group were as follows: (1) average age, 63 years (22-93 years) vs 51 years (2-89 years) (p = 0.03), (2) alcohol consumption, 77.8 % vs 25 % (p = 0.03), (3) tobacco use, 64 % vs 25 % (p = 0.006), and (4) chronic liver disease, 21 % vs 1.5 % (p = 0.002). Age was the only significant RF identified using multivariate analysis. Overall, 27 % of patients had an invasive pasteurellosis and experienced significant mortality (11 %). Advanced age, chronic liver disease were the main RFs associated with invasive pasteurellosis. Healthcare providers should be aware of these RFs when patients are exposed to cats or dogs.

Bacteria isolated from conspecific bite wounds in Norway and black rats: implications for rat bite-associated infections in people

Bites associated with wild and domestic Norway and black rats (Rattus norvegicus and Rattus rattus) may have a variety of health consequences in people. Bite-related infections are among the most significant of these consequences; however, there is little data on the infectious agents that can be transmitted from rats to people through biting. This is problematic because without an accurate understanding of bite-related infection risks, it is difficult for health professionals to evaluate the adequacy of existing guidelines for empirical therapy. The objectives of this study were to increase our knowledge of the bacterial species associated with rat bites by studying bite wounds that wild rats inflict upon one another and to review the literature regarding rat bites and bite wound management. Wild Norway and black rats (n=725) were trapped in Vancouver, Canada, and examined for bite wounds in the skin. All apparently infected wounds underwent aerobic and anaerobic culture, and isolated bacteria were identified. Thirty-six rats had bite wound-related infections, and approximately 22 different species of bacteria belonging to 18 genera were identified. Staphylococcus aureus was the most common isolate; however, the majority of infections (72.5%) were polymicrobial. Rat bites can result in infection with a number of aerobic and anaerobic Gram-positive and Gram-negative bacteria. In humans, these wounds are best managed through early recognition and cleansing. The benefit of prophylactic antimicrobial treatment is debatable, but given the deep puncturing nature of rodent bites, we suggest that they should be considered a high risk for infection. Antibiotics selected should include coverage for a broad range of bacterial species.

A case of wound dual infection with Pasteurella dagmatis and Pasteurella canis resulting from a dog bite -- limitations of Vitek-2 system in exact identification of Pasteurella species

Background

Pasteurella species, widely known as indigenous orgganisms in the oral and gastrointestinal floras of many wild and domestic animals, are important pathogens in both animals and humans. Human infections due to Pasteurella species are in most cases associated with infected injuries following animal bites. We encountered a rare case of dual infections caused by different two Pasteurella species occurred in a previously healthy 25-year-old female sustaining injury by a dog-bite.

Methodology

Exudates from the open wound of her dog-bite site, together with the saliva of the dog were submitted for bacteriological examination. Predominantly appearing grayish-white smooth colonies with almost the same colonial properties but slightly different glistening grown on chocolate and sheep blood agar plates were characterized morphologically by Gram's stain, biochemically by automated instrument using Vitek 2 system using GN cards together with commercially available kit system, ID-Test HN-20 rapid panels, and genetically by sequencing the 16S rRNA genes of the organism using a Taq DyeDeoxy Terminator Cycle Sequencing and a model 3100 DNA sequencer instrument.

Results

The causative isolates from the dog-bite site were finally identified as P. canis and P. dagmatis from the findings of the morphological, cultural, and biochemical properties together with the comparative sequences of the 16S rRNA genes. Both the isolates were highly susceptible to many antibiotics and the patient was successfully treated with the administration of so-called the first generation cephalosporin, cefazolin followed by so-called the third generation cephalosporin, cefcapene pivoxil. The isolate from the dog was subsequently identified as P. canis, the same species as the isolate from the patient.

Conclusions

To the best of our knowledge, this was the second report of a dual infection with Pasteurella species consisting of P. dagmatis and P. canis resulting from a dog-bite, followed by the first report of dual infections due to P. dagmatis and P. multocida in 1988. Our isolate finally identified as P. dagmatis was misidentified as P. pneumotripica by means of the Vitek 2 system. The species name "P. dagmatis" was not included in the database of the system. It is also important for routine clinical microbiology laboratories to know the limitation of the automated Vitek 2 system for the accurate identification of Pasteurella species especially P. dagmatis. It should be emphasized that there still exists much room for improvement in Vitek 2 system. Significant improvement of Vitek 2 system especially in the identification of Pasteurella species is urgently desired.

Deathly drool: evolutionary and ecological basis of septic bacteria in Komodo dragon mouths

Komodo dragons, the world's largest lizard, dispatch their large ungulate prey by biting and tearing flesh. If a prey escapes, oral bacteria inoculated into the wound reputedly induce a sepsis that augments later prey capture by the same or other lizards. However, the ecological and evolutionary basis of sepsis in Komodo prey acquisition is controversial. Two models have been proposed. The “bacteria as venom” model postulates that the oral flora directly benefits the lizard in prey capture irrespective of any benefit to the bacteria. The “passive acquisition” model is that the oral flora of lizards reflects the bacteria found in carrion and sick prey, with no relevance to the ability to induce sepsis in subsequent prey. A third model is proposed and analyzed here, the “lizard-lizard epidemic” model. In this model, bacteria are spread indirectly from one lizard mouth to another. Prey escaping an initial attack act as vectors in infecting new lizards. This model requires specific life history characteristics and ways to refute the model based on these characteristics are proposed and tested. Dragon life histories (some details of which are reported here) prove remarkably consistent with the model, especially that multiple, unrelated lizards feed communally on large carcasses and that escaping, wounded prey are ultimately fed on by other lizards. The identities and evolutionary histories of bacteria in the oral flora may yield the most useful additional insights for further testing the epidemic model and can now be obtained with new technologies.

Diabetes in patients with pasteurellosis

From 1991 to 2003, 20 patients with pasteurellosis were admitted to our unit, of whom 2 died. They presented with cellulitis (n = 14), arthritis (n = 6), pneumonia (n = 3), subcutaneous abscess (n = 3), bursitis (n = 2), meningitis, otitis, sinusitis and uveitis. Underlying diseases included diabetes (n = 6) and malignancy (n = 5). Diabetes could be a predisposing condition for pasteurellosis.

Subcellular distribution of Plp-40, a lipoprotein in a serotype A strain of Pasteurella multocida

A 40-kDa lipoprotein (Plp-40) is expressed by serotype A strains of Pasteurella multocida in amounts which correlate with the amount of capsular material present. We hypothesized that Plp-40 is exposed at the outer surface of the outer membrane (OM) of the cell and is associated with the serotype A exopolysaccharide material. The objectives of the present study were to confirm the lipoprotein nature of Plp-40 and to determine its subcellular location. Plp-40 maturation was shown to be sensitive to globomycin, thereby confirming it to be a bacterial lipoprotein. Plp-40 was shown to be present in the OM fractions of P. multocida obtained by both sarkosyl extraction and sucrose density gradient centrifugation, as well as in capsule fractions obtained by either hyaluronidase treatment or warm buffer extraction. [(3)H]palmitic acid-labeled Plp-40 could be removed from the surface of whole cells by exposure to proteinase K. Autoradiography of (125)I-labeled cell surface proteins exhibited a 40-kDa band that was prominent in capsulated strains and greatly diminished in a noncapsulated strain. These results support the hypothesis that Plp-40 is a lipid-modified OM protein, which is exposed on the outer cell surface and is likely associated with serotype A extracellular polysaccharide.

Pasteurella multocida meningitis: case report and review of the literature

Pasteurella multocida forms part of the normal flora in the nasopharynx of many domestic and wild animals. Most human P. multocida infections are soft tissue infections due to animal bites. P. multocida meningitis is a rare condition. We report a case of P. multocida meningitis with a complicated outcome and review the literature of this condition.

Bacteriemia por Pasteurella spp.: una entidad infrecuente durante los últimos 8 años en nuestro centro

OBJECTIVES

To review and update the epidemic and clinical knowledge concerning disseminated blood disease caused by Pasteurella species in our area.

METHODS

Retrospective study of Pasteurella species bacteremia (PSB) episodes occurring in patients attended from January 1994 to December 2001 in a single tertiary hospital.

RESULTS

Among the 31 clinical samples remitted to the Microbiology Laboratory in which a species of Pasteurella was identified, 5 (16%) corresponded to positive blood cultures in 5 patients. Pasteurella multocida was the predominant species, identified in 70% of all isolations and all but one positive blood culture. All the patients were adults over 50 years old and all had underlying illnesses causing comorbidity or some degree of immunocompromise, with cardiovascular and hypertensive conditions being the most frequent; only one patient had liver cirrhosis. In all cases, except one, contact or coexistence with dogs or cats was documented. The clinical presentation of PSB was non-specific and only two episodes were related with a possible focal, soft-tissue origin. There were no serious complications, such as septic shock, organ failure or invasive disease (meningitis or endocarditis). All patients cured with antimicrobial treatment, although surgical debridement of infected bite wounds was required in two cases. The betalactams and other families of antibiotics showed excellent in vitro activity against the five strains of Pasteurella isolated.

CONCLUSIONS

PSB occurred in adult patients having a wide range of underlying illnesses and comorbidity factors. Most of them had contact with pets, though traumatic lesions were not present in all cases. Clinical presentation did not differ from other types of severe sepsis. Susceptibility and outcome of primary treatment with penicillins and other betalactams shows that they are still appropriate therapy. More emphasis should be placed on preventive measures related to care and hygiene among individuals with pets.

Pet-assisted therapy in the nursing home setting: potential for zoonosis

Pet-assisted therapy in the nursing home setting, as a vital component of the Eden Alternative or Human Habitat program, is gaining widespread recognition and implementation. Programs such as this help to improve the quality of life of nursing home residents by offsetting resident loneliness, helplessness, and boredom. However, use of companion animals (and, frequently, birds and fish) may be associated with the introduction of infectious entities that are normally uncommon in this setting (zoonosis). Examples include psittacosis, bartonellosis, toxocariasis, Capnocytophaga canimorsus, pasturellosis, Q fever, and leptospirosis, to name but a few. Hence vigilance for unusual clinical manifestations that may herald such diseases is necessary. In addition, prevention of such illnesses by routine veterinary screening of both resident and visiting companion animals is mandatory. Infection control policies and procedures geared toward management and prevention of zoonotic illnesses should be developed and implemented in all nursing homes offering pet-assisted therapy.

Localization of the intracellular activity domain of Pasteurella multocida toxin to the N terminus

We have shown that Pasteurella multocida toxin (PMT) directly causes transient activation of Gqalpha protein that is coupled to phosphatidylinositol-specific phospholipase Cbeta1 in Xenopus oocytes (B. A. Wilson, X. Zhu, M. Ho, and L. Lu, J. Biol. Chem. 272:1268-1275, 1997). We found that antibodies directed against an N-terminal peptide of PMT inhibited the toxin-induced response in Xenopus oocytes, but antibodies against a C-terminal peptide did not. To test whether the intracellular activity domain of PMT is localized to the N terminus, we conducted a deletion mutational analysis of the PMT protein, using the Xenopus oocyte system as a means of screening for toxin activity. Using PCR and conventional cloning techniques, we cloned from a toxinogenic strain of P. multocida the entire toxA gene, encoding the 1,285-amino-acid PMT protein, and expressed the recombinant toxin as a His-tagged fusion protein in Escherichia coli. We subsequently generated a series of N-terminal and C-terminal deletion mutants and expressed the His-tagged PMT fragments in E. coli. These proteins were screened for cytotoxic activity on cultured Vero cells and for intracellular activity in the Xenopus oocyte system. Only the full-length protein without the His tag exhibited activity on Vero cells. The full-length PMT and N-terminal fragments containing the first 500 residues elicited responses in oocytes, but the C-terminal 780 amino acid fragment did not. Our results confirm that the intracellular activity domain of PMT is localized to the N-terminal 500 amino acids of the protein and that the C terminus is required for entry into cells.

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.

Pasteurella multocida septicemia and subsequent Pasteurella dagmatis septicemia in a diabetic patient

Pasteurella species may cause zoonotic infections of humans. Serious systemic infections with these organisms are unusual, but they may occur in individuals with predisposing underlying illnesses. Occurrences of bacteremia due to P. multocida are infrequent, and P. dagmatis bacteremia is even rarer. We report independent occurrences of P. multocida and P. dagmatis septicemia in the same diabetic patient after contact with two pet dogs. We review the history of Pasteurella species and discuss the biochemical and clinical features of its association with zoonosis.

The management of dog bites and dog bite infections to the hand

Dog bites account for approximately one of 200 emergency room visits. The majority of bites are from dogs known to the victim. Due to the numerous small compartments and the thin covering of soft tissue over the bones and joints, bite wounds to the hand are more likely to become infected that are bites to the arm, leg, or face. Improper management can result in significant morbidity and prolonged treatment. This article discusses the microbiology of dog bite wounds, antibiotic selection, and proper wound management.

Pasteurella multocida meningitis in a two-day old neonate

A normal full-term baby boy, born by vaginal delivery, became ill on day 2 with fever and failure to feed. CSF examination revealed 260 x 10(6)/l leucocytes, mainly mononuclears, protein 2 g/l and glucose zero. Pasteurella multocida was isolated in pure culture from the baby's CSF, blood and umbilicus and from the mother's vagina. The baby was treated with i.v. penicillin for 7 weeks. Progress was complicated by mild hydrocephalus, which resolved, and prolonged low grade fever. Recovery was complete, without neurological sequelae. This case illustrates that P. multocida can infect the vagina where it presents a hazard to a newborn infant delivered vaginally. Early diagnosis is critical, intravenous high dose penicillin being the treatment of choice.

Characterization and distribution of Pasteurella species recovered from infected humans

During a 3-year period, all Pasteurella strains recovered at the Clinical Microbiological Laboratory, Lund, Sweden, were studied biochemically with respect to their relationship to the recently described taxa of this genus. Of 159 strains recovered from 146 infected humans, 95 were identified as Pasteurella multocida subsp. multocida, 21 as Pasteurella multocida subsp. septica, 28 as Pasteurella canis, 10 as Pasteurella stomatis, and 5 as Pasteurella dagmatis. The homology within and between the Pasteurella species regarding cellular fatty acids and enzymatic activities was also studied. Strains of the different Pasteurella species were indistinguishable from each other regarding fatty acid composition; all strains contained major amounts of C14:0, C16:1, C16:0, and 3-OH-C14:0 acids and minor amounts of C18:2, C18:1, and C18:0 acids. Neither did the enzymatic activities distinguish between strains belonging to different species. In addition, of 56 strains examined, toxin production was demonstrated only in 1 strain each of P. multocida subsp. multocida and P. canis. Except for one severe case of necrotizing cellulitis involving P. dagmatis, P. multocida subsp. multocida or P. multocida subsp. septica was recovered in the more serious cases of infection. Except for P. canis, which in all cases was associated with dog bites, most Pasteurella strains were recovered in cases of infection associated with cat bites or scratches. Pasteurella strains occurred in four infected patients without evident connections with animals.

Severe Pasteurella multocida infections in pregnant women

We report 2 cases of severe infections due to Pasteurella multocida, both occurring during pregnancy in previously healthy women. Both women had contact with animals (dog and cat) but neither of them had been bitten. Apart from a slight decrease in IgG levels, no immunological defects could be detected. Both women had received oral phenoxymethylpenicillin in the early phase of the disease, but still fell ill with severe infections. One woman had meningitis while the other suffered from cellulitis with deep abscess formation.

Pasteurella multocida corneal ulcer following a baseball injury

Pasteurella multocida is an ubiquitous organism that can be isolated from a variety of animals and birds. It is an infrequent ocular pathogen but can cause infection as a result of injury or animal exposure. This article reports a case of P multocida corneal ulcer following a baseball injury.

Lack of in vitro efficacy of oral forms of certain cephalosporins, erythromycin, and oxacillin against Pasteurella multocida

The in vitro susceptibility of human isolates of Pasteurella multocida to oral antimicrobial agents from our current study and from a review of the literature suggests that dicloxacillin (oxacillin), erythromycin, clindamycin, cephalexin, cefaclor, and cefadroxil should not be used for empiric therapy of animal bite wounds. Agents that were consistently active against P. multocida were penicillin, ampicillin, amoxicillin-clavulanic acid, tetracycline, minocycline, chloramphenicol, trimethoprim-sulfamethoxazole, and cefuroxime. Possible reasons for the confusion regarding the activity of oral cephalosporins are addressed.

Fatal Pasteurella multocida septicaemia following a cat bite in a man without liver disease

We report a fatal case of septicaemia caused by Pasteurella multocida that followed a cat bite. The patient, a man aged 54 years, was not suffering from disease of the liver but had a history of ischaemic heart disease, non-insulin-dependent diabetes mellitus and rheumatoid arthritis which had been treated with steroids for 13 years.

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.

Isolation of Pasteurella multocida in a patient with spontaneous peritonitis and liver cirrhosis

A case of spontaneous bacterial peritonitis caused by Pasteurella multocida in a 12 year old boy with previously undiscovered cirrhosis of the liver is reported. This case is discussed and related to eight published cases of spontaneous peritonitis caused by Pasteurella multocida in adults, seven with cirrhosis of the liver and/or alcohol abuse, and one with systemic lupus erythematosus complicated by membranoproliferative glomerulonephritis. It would appear that spontaneous bacterial peritonitis caused by Pasteurella multocida is not confined to adults with a history of alcohol abuse or cirrhosis of the liver, but can also affect children with non-alcoholic cirrhosis of the liver.

Cephradine in the prophylactic treatment of dog bites

Four hundred and twenty patients with one or more open dog bite wounds were studied. Cephradine or no antibiotic was used for treatment. The wounds were debrided, irrigated, and dressed; 3.6% required suturing. Six patients treated prophylactically with cephradine developed wound infections and three of these had to be hospitalized in order to receive parenteral antibiotics. Five of the wounds grew Enterobacter species, and the sixth grew Pseudomonas aeruginosa. In the control group, only two patients developed infections, one with Staphylococcus aureus, and the other with Bacillus subtilis. Both were treated as outpatients with oral antibiotics after wound treatment. Although there is no statistically significant difference between the prophylactic and control groups, there was a trend toward more serious infections in those treated with cephradine. This investigation demonstrates that prophylactic cephradine is not useful in cases of uninfected dog bite wounds.

Rabies therapy for animal bites in the head and neck region

Facial wounds inflicted by bites and scratches during an animal attack require proper wound management and the formulation of a rational treatment plan that considers an important possible sequela--rabies. Presented is a review of the current protocol for the proper evaluation and management of this condition.

Pasteurella multocida: bilateral septic knee joint prostheses from a distant cat bite

We report a case of septic arthritis and bacteremia caused by the Gram-negative rod, Pasteurella multocida. The patient was superficially bitten by her cat, and within two years infection necessitated removal of both of her artificial knee prostheses. P multocida is found in the mouths of cats, dogs, and other domestic animals. The pathogenesis, prevention, and treatment of infections caused by this organism, and the question of prophylactic antibiotics are discussed.

Meningitis and bacteremia caused by Pasteurella multocida. A case report

A case of pasteurella multocida meningitis in a 75-year old woman with chronic otitis media is reported. There were no unusual clinical features of meningitis in this case which distinguished it from meningitis due to other pyogenic bacteria. P. multocida is characterized by a distinctive biochemical pattern, and correct identification should not be difficult provided that the possibility of its occurrence in meningitis is kept in mind.

Exposure to rabies - an occupational hazard for veterinarians

Interviews to solicit information about animal bites and rabies vaccinations were completed on 1165 of 1175 non-military veterinarians in Illinois in 1968. Two hundred and sixty-one veterinarians reported 380 exposure incidents that precipitated the administration of rabies vaccine; 72 veterinarians had received two or more series of vaccine. Vaccine was administered after exposure from: examination of a patient (n = 230), bite (n = 79), necropsy (n = 17), other causes (n = 13) and unstated (n = 41). Eighty-six percent of the exposures were to dogs or cattle. In 231 veterinarians receiving postexposure vaccinations, where year of first vaccination and year of graduation from veterinary school were known, 97 (42%) were exposed in the six years spanning one year before graduation and four years after graduation. There were 296 veterinarians, including 12 receiving postexposure vaccination, who had received their first series of vaccine as preexposure prophylaxis. Twenty-one percent of all vaccinees (pre- and postexposure) reported reactions to the rabies vaccine. Seventy-two veterinarians reported they had been treated for an animal bite in the previous year.