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Case Study Pathogenic Bacteriology 2009. Case #7, 34, 64 Evelyn Loi Hien Dang Jose Cervantes Jr. Case Summary. 8:00am 65-year-old woman bitten by her cat on dorsal aspect of the right middle finger. 4:00pm swelling and pain the finger and dorsum of the right hand.

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case study pathogenic bacteriology 2009

Case StudyPathogenic Bacteriology2009

Case #7, 34, 64

Evelyn Loi

Hien Dang

Jose Cervantes Jr.

case summary
Case Summary

8:00am

65-year-old woman bitten by her cat on dorsal aspect of the right middle finger.

4:00pm

swelling and pain the finger and dorsum of the right hand.

pain in the axilla, red streaking up the forearm, and chills.

Body temperature: 38oC

Lab

Aspiration of abscess sent for culture

Operating room

Incision and drainage of abscess

key information pointing to diagnosis
Key Information Pointing to Diagnosis

Age

Body temperature

38oC

Arm

Red streaking

Pain in axilla

Hand

Erythema

Swelling

Warmth

Tenderness of finger

Elevated WBC

12,000 /microliter

classification gram stain results and microscopic appearance of pathogen
Classification,Gram Stain Results, and Microscopic Appearance of Pathogen

1. Which organism was isolated on culture of the abscess?

Family: Pasteurellacaea

Genus: Pasteurella

Species: multocida

Gram –

Coccobacilli

Bipolar staining

Fermentative

Non-motile

Facultative anaerobe

diagnosis isolation identification of pathogen
Diagnosis/Isolation/Identification/ of Pathogen

Media

No growth on Mac plate

Growth on Chocolate and Blood Agar

Biochemical testing

Oxidase +

Indole +

Catalase+

Nitrate +

Urease -

diseases and pathogenesis of disease caused by p multocida
Diseases and Pathogenesis of Disease Caused by P. multocida

Virulence Factor

Endotoxin

Capsule

What is the reservoir of this organism? How do humans most commonly become infected by this organism?

Upper respiratory tract of pets and farm animals as NF

Bites or scratches inflicted by dogs and cats

diseases caused by pasteurella
Diseases caused by Pasteurella
  • Soft tissue inflammation
    • Purulent wounds, cellulitis, abscesses
  • Deep soft-tissue inflammation
    • Tenosynovitis
    • Septic arthritis
    • Osteomyelitis

Which other clinical syndromes can be caused by this organism?

  • Systemic infection (rare)
    • Endocarditis
    • Meningitis
  • Eyes
    • Conjunctivitis
    • Corneal ulcer
  • Respiratory
    • Pharangitis
    • Pneumonia (patients with underlying pulmonary disease)
therapy and prognosis of patient infected with p multocida
Therapy and Prognosis of Patient Infected with P. multocida

Cat bites are worse than dog bites because of their small, sharp and penetrative teeth.

Aggressive organism

Symptoms appear within 24 hours

Sensitive to antibiotics

Antibiotics

Highly sensitive to Penicillin

Chloramphenicol

Tetracyclin

Ciprofloxins

slide9

How can infection with this organism be prevented?

  • Young infants should avoid contact with the saliva of dogs and cats
  • Inform immunocompromised patients and children about Pasteurella infection and animal exposure
  • Don’t pet strange animals
  • Never bother an animal that is eating or sleeping
  • Be sure household pets are up to date on their vaccinations
  • Seek medical advice if there is redness, swelling, or pain if you suffer an animal bite.
slide10
Primary Research Article Contributing to the Understanding of the Disease caused by Pasteurella multocida

Freshwater, A. (2008). Why Your Housecat’s Trite Little Bite Could Cause You Quite a Fright: A Study of Domestic Felines on the Occurrence and Antibiotic Susceptibility of Pasteurella multocida. Zoonoses and Public Health. 55:507-513.

Purpose

Identify potential antibiotic resistance

Examine carriage rate

Materials and Methods

Specimen collection

409 veterinary clinics, humane shelters, private residence

Cats’s gingival margins

Culture and ID of specimens

CBA, MacConkey

Antibiotic susceptibility testing

Penicillin and Penicillin derivatives

G-tests

Age, breed, food type, gingival scale, lifestyle and sex

slide11

Results & Discussion

  • G test
    • No significant relationship between individual factors and the presence of P. multocida
    • Carriage rate is 90%
  • Susceptibility testing
    • Penicillin (Penicillin derivatives) is still the suitable method to treat cat bite wounds
  • Canine bites far outnumber cat bites
    • 20-80% of all cat bite wounds become infected
    • 3-18% of dog bite wounds become infected

Table 1 % Susceptibility in 409 isolates of Pasteurella multocida

Table 2 Characterization of Pasteurella multocida

take home message
Take Home Message

Pasteurella multocida

Diseases usually involves domestic animals such as cats and dogs

Typical symptoms

abscess and cellulitis at local wounds

Fever

Elevated white blood cells

Diagnostics

Antimicrobial susceptibility testing

Pasteurellacan be aggressive (symptoms within 24 hours) however it can be treated easily.

Penicillin

Prevention

Inform children and immunocompromised individuals about Pasteurella infection and animal exposure.

Transmission

animal bite, scratches, licks, and inhalation

references
References

Freshwater, A. (2008). Why Your Housecat’s Trite Little Bite Could Cause You Quite a Fright: A Study of Domestic Felines on the Occurrence and Antibiotic Susceptibility of Pasteurella multocida. Zoonoses and Public Health. 55:507-513.

Bryant, Barbara J. et al. (2007). Pasteurella multocida bacteremia in asymptomatic plateletpheresis donors: a tale of two cats. Transfusion. 47: 1984-1989.

Green, Bryant T. et al. (2001). Pasteurella multocida Meningitis: Case Review of the last 11 Y. Scand J Infect Dis. 34:213-217

Loiez, Caroline et al. (2002). Pasteurella multocida and Intrauterine Device: A Woman and her Pets. Scand J Infect Dis. 34:473-474

Wade, T. et al. (1999). Pasteurella multocida meningitis in infancy- (a lick may be as bad as a bite). Eur J Pediatr 158: 875-878

Kimura, Ryosuke et al. (2004) Pasteurella multocida septicemia caused by close contact with a domestic cat: case report and literature review. J Infect Chemoter. 10: 250-252

McQueen, Nancy. Winter 2009. Pasteurellacaea.