Fatal Pasteurella multocida septicemia and necrotizing fasciitis related with wound licked by a domestic dog
ABSTRACT A 68-y-old male had necrotizing fasciitis and bacteremia due to Pasteurella multocida. Saliva culture from his dog grew P. multocida and Pseudomonas aeruginosa. The human and dog P. multocida strains were of the same antibiogram but not identical tested with ribotyping. The wound licked by his dog was the only risk factor.
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ABSTRACT: BACKGROUND: In humans, rapidly developing Pasteurella multocida cellulitis after a cat scratch or bite is a well-known entity that sometimes progresses to necrotizing fasciitis and can be fatal. CASE REPORT: A 3-year-old female spayed whippet dog developed ecchymosis, swelling and pain within 24 h of being scratched by a cat on the ventral thorax. Over the following days, while being treated only with pain medications, the lesions rapidly progressed into haemorrhagic bullae with expanding skin necrosis. A heavy growth of P. multocida was seen on bacterial cultures, and histological examination showed marked, suppurative panniculitis with necrosis of the epidermis, dermis and panniculus. Special histological stains highlighted a moderate amount of Gram-negative coccobacilli admixed with inflammatory cells. Complete resolution was achieved with surgical debridement, skin grafting and intravenous antibiotic treatment. Positive bacterial culture for P. multocida, in conjunction with the history, clinical findings, histology results and the rapid response to therapy, strongly supports a diagnosis of P. multocida necrotizing cellulitis. CONCLUSIONS AND CLINICAL IMPORTANCE: Complications of cat bite-associated P. multocida infections in humans are well known. To the authors' knowledge, this is the first documentation of P. multocida necrotizing cellulitis in a dog following a cat scratch wound. This case highlights the rapidity and severity of P. multocida cellulitis, if not recognized and treated early. Veterinarians should include P. multocida in the differential diagnosis of any local wound infection following a cat scratch.Veterinary Dermatology 06/2013; 24(4). DOI:10.1111/vde.12038 · 1.99 Impact Factor
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ABSTRACT: We present a case of fulminant Pasteurella multocida sepsis in a 66-year-old man who had undergone a renal transplant. Our patient lived with two dogs and a cat with which he was very close. We propose that his bacteraemia might have resulted from direct inoculation of P multocida via his cat licking the venous stasis ulcers on his legs. The patient's clinical course was complicated by cardiopulmonary failure and he ultimately succumbed to his infection. P multocida is a rare cause of infections in immunocompromised hosts, epidemiologically linked to exposure to cats, dogs, and other animals. This case of P multocida shows the importance of considering this organism in immunocompromised hosts presenting with severe infections, especially if their history shows exposure to domesticated or wild animals known to be potential carriers of this disease. In this Grand Round, we review the clinical features, epidemiology, treatment, and prognosis of P multocida infections with a focus on these features in patients who are immunosuppressed. Copyright © 2014 Elsevier Ltd. All rights reserved.The Lancet Infectious Diseases 11/2014; 15(2). DOI:10.1016/S1473-3099(14)70895-3 · 19.45 Impact Factor
Article: Microbiology of Animal Bites[Show abstract] [Hide abstract]
ABSTRACT: While animal interaction is largely a rewarding human endeavor, every year millions of people are bitten by animals, and most of these bites are inflicted by dogs and cats. While most of the bites do not require medical attention, some progress to a local soft tissue infection at the site of the injury. Like most cutaneous wound infections, the resultant infection is typically a polymicrobial mix consisting of common environmental organisms. However, a multitude of species-specific, soft tissue zoonoses are spread through animal bites. The pathogenic organisms may exist as normal salivary flora or may be present as part of a symptomatic or even asymptomatic infection in the animal. We concisely review the soft tissue infections caused by several species-specific pathogens transmitted through animal bites, with focus on dogs and cats, as they are by far the most commonly implicated species in human bite wounds.Clinical Microbiology Newsletter 04/2008; 30(7):47-50. DOI:10.1016/j.clinmicnews.2008.03.001