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        History and Physical Patients with Pasteurella multocida infection will most commonly present following an injury due to an animal scratch or bite. Evaluation Patients presenting with an animal bite or scratch should receive an X-ray of the affected area to evaluate for any fractures, retained foreign body, signs of osteomyelitis, or signs of necrotizing infection.Management of Complicated Infected Injury Complications of infected injury include systemic illness fever, hypotension, tachycardia and spread to deeper soft tissues.Antibiotic Therapy or Prophylaxis The first-line antibiotic for prophylaxis or active local infection is oral amoxicillin-clavulanate. Differential Diagnosis While Pasteurella multocida is the most common pathogen isolated from animal bites or scratches, these other pathogens should also be considered: Bartonella henselae.Prognosis Soft-tissue infections associated with Pasteurella multocida generally have an uncomplicated course and resolve with appropriate treatment. Complications If prompt treatment is not initiated for an infected animal bite, complications may occur. Consultations Surgical consultation may be required if the patient requires abscess drainage, wound debridement, or extensive reconstruction. Deterrence and Patient Education Both patients that are classified as high-risk, as well as those sustaining high-risk injuries, should be promptly evaluated by a medical professional after injury via an animal bite or scratch.Enhancing Healthcare Team Outcomes Management of Pasteurella multocida infection may require multiple medical specialties to cooperate and interact. Review Questions Access free multiple choice questions on this topic. Comment on this article. References 1. Pasteurella multocida line infection: a case report and review of literature. BMC Infect Dis. Pasteurella multocida--the major cause of hand infections following domestic animal bites. J Hand Surg Am.Pasteurella infections in a tertiary centre - from cellulitis to multiple-organ failure: Retrospective case series. Pasteurella multocida pneumonia in an immunocompetent patient: Case report and systematic review of literature. Lung India. Clinical Features and Outcomes of Pasteurella multocida Infection. Medicine Baltimore. Wilson BA, Ho M.Pasteurella multocida: from zoonosis to cellular microbiology. Clin Microbiol Rev. Arch Pediatr. Pasteurella multocida infections. Report of 34 cases and review of the literature. Pasteurella multocida in animals' mouths. Rocky Mt Med J. Bacteriologic analysis of infected dog and cat bites. N Engl J Med. Necrotizing fasciitis due to Pasteurella multocida infection. Prosthetic joint infection caused by Pasteurella multocida: a case series and review of literature.Morgan M, Palmer J. Dog bites. Predictors of infection from dog bite wounds: which patients may benefit from prophylactic antibiotics? Emerg Med J. Practice guidelines for the diagnosis and management of skin and soft tissue infections: update by the infectious diseases society of America. Clin Infect Dis. Kannikeswaran N, Kamat D. Mammalian bites. Clin Pediatr Phila. Pasteurella Multocida. In: StatPearls [Internet]. 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. Pasteurella grows readily on chocolate and sheep-blood agar media, but fails to grow on MacConkey agar, the usual medium for Gram-negative bacteria.Strains are usually catalase-, oxidase-, indole- and sucrose-positive. Penicillins and potentiated beta-lactamics amoxicillin-clavunalate potassium are first line antibiotics for the treatment of Pasteurella infections Roy et al. Quinolones, cephalosporins and modern macrolids are also indicated Freshwater,  All 84 P. In severe cases, the therapeutic decision must be based on antibiotic susceptibility tests.Severe infections are usually seen in children, pregnant women, patients on chronic immunosuppressive therapy, and immunocompromised persons. Chronic liver disease and cirrhosis entail a special risk of sepsis and peritonitis by Pasteurella spp.Adler et al. Although severe disease generally appears in immunocompromised persons, about one third of septicaemic patients were previously healthy individuals Kimura et al. Apart from bites, scratches and licks, close contact has also been sufficient for infection. Inhalation of secretion droplets from the upper respiratory tract is a possible source of infection Kimura et al. Occasionally, the local infection can progress to necrotising fascitis, septic arthritis and osteomyelitis Layton,  Respiratory infection, pneumonia and bronchopneumonia also are common, mostly in patients with pre-existing lung disease Perez Garcia et al.Less frequently, a disseminating infection may produce septicaemia, which may lead to septic shock, meningitis, endocarditis, peritonitis, arthritis and other serious consequences Perez Garcia et al.Pasteurella peritonitis through a dialysis catheter after contact with a cat has been reported Rondon-Berrios and Trebejo-Nunez, ; Sol et al.Practical guidelines for susceptibility testing of Pasteurella strains. South Med J. The earliest comprehensive review of bone and joint infections caused by Pasteurella species. Succinct discussion of animal and human bites with a concise table of recommendations for the management of bite wounds.Scand J Infect Dis. Concise review of mechanisms of pathogenesis. This is the first good study that linked clinical conditions to specific Pasteurella species and subspecies. Clin Infect Dis. Latest guidelines for susceptibility testing that includes Pasteurella species. Landmark study reporting the complete P. Medeiros, I, Saconato, H. Cochrane Database Syst Rev.An evidence-based review of the medical literature that assesses the available evidence for antimicrobial prophylaxis following animal bites. Adv Med Sci. Case report and literature review of around cases of Pasteurella infections in individuals with cirrhosis. Arch Dis Child Fetal Neonatal. Detailed review of 25 cases of neonatal infections, mainly septicemia and meningitis, nearly all with a history of animal exposures; some infections by vertical transmission.Am J Med Sci. Review of case reports of intra-abdominal Pasteurella infections. These are evidence-based guidelines that address the empirical antimicrobial approach to animal bites taking into consideration the likelihood of Pasteurella.Medicine Baltimore. This is the first major review of the literature that defined the epidemiology and clinical spectrum of Pasteurella infections in humans. All rights reserved. No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. Show More. Login Register. Enjoying our content? Thanks for visiting Infectious Disease Advisor. If you wish to read unlimited content, please log in or register below.Registration is free. Register for free and gain unlimited access to:. What should you expect to find? Continue Reading. Table I. How did the patient develop Pasteurella infection? What was the primary source from which the infection spread? Which individuals are of greater risk of developing Pasteurella infection? Beware: there are other diseases that can mimic Pasteurella infection: What laboratory studies should you order and what should you expect to find?What imaging studies will be helpful in making or excluding the diagnosis of Pasteurella infection? What consult service or services would be helpful for making the diagnosis and assisting with treatment? If I am not sure what pathogen is causing the infection what anti-infective should I order? What complications could arise as a consequence of Pasteurella infection? What should you tell the family about the patient's prognosis?How do you contract Pasteurella infection and how frequent is this disease? What pathogens are responsible for this disease? How do these pathogens cause Pasteurella infection?  

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