Pasteurellosis

Pasteurellosis
Other names: Pasteurella infection
Gram-stained photomicrograph depicting numerous Pasteurella multocida bacteria
Specialty	Infectious diseases
Symptoms	Swelling, Erythema, Tenderness[1]
Complications	Abscesses, osteomyelitis[2]
Types	Subcutaneous tissue disease,pneumonia disease or sepsis
Causes	Pasteurella multocida[2]
Diagnostic method	PCR[3]
Treatment	Co-amoxiclav[2]
Frequency	714 cases (UK 2013)[2]

Pasteurellosis (or Pasteurella infection^[4]) is an infection with a species of the bacterial genus Pasteurella,^[5] which is found in humans and other animals.

Pasteurella multocida (subspecies P. m. septica and P. m. multocida) is carried in the mouth and respiratory tract of various animals, including pigs. It is a small, Gram-negative bacillus with bipolar staining by Wayson stain. In animals, it can originate in fulminant septicaemia (chicken cholera), but is also a common commensal.^[6][1][2]

Until taxonomic revision in 1999, Mannheimia spp. were classified as Pasteurella spp., and infections by organisms now called Mannheimia spp., as well as by organisms now called Pasteurella spp., were designated as pasteurellosis. The term "pasteurellosis" is often still applied to mannheimiosis, although such usage has declined.^[7]

Types

The several forms of the infection are as follows (other locations are possible, such as meningitis, and acute endocarditis, but are very rare):^[8][9][1]

• Skin/subcutaneous tissue disease is a septic phlegmon that develops classically in the hand and forearm after a cat bite. (Inflammatory signs are very rapid to develop; in 1 or 2 hours, edema, severe pain, and serosanguineous exudate appear. Fever, moderate or very high, can be seen, along with vomiting, headache, and diarrhea. Lymphangitis is common. Complications are possible, in the form of septic arthritis, osteitis, or evolution to chronicity.)^[1]
• Pneumonia disease is also rare and appears in patients with some chronic pulmonary pathology. It usually presents as bilateral consolidating pneumonia, sometimes very severe.
• Septic arthritis is common in individuals with comorbidities

Signs and symptoms

a) Inflammatory oedema both upper and lower lids with purulent encystment b) contrast medium shows absence of intra-orbital extension arrow c) evidence of gram-negative bacilli. d) smooth, grey, non hemolytic colonies cultured on blood agar e) positive oxydase test f) API-20E array results g) lessening of inflammatory oedema after amoxicillin administration

The clinical presentation is a local wound infection which can become a serious soft tissue infection^[2]

This can have the following manifestation:^[1]

• Swelling
• Erythema
• Tenderness
• Purulent drainage

Cause

a) Release of outer membrane vesicles from Pasteurella multocida. b) Pasteurella multocida OMVs negatively stained

Pasteurella multocida is a Gram-negative, nonmotile, penicillin-sensitive coccobacillus of the family Pasteurellaceae.^[1]

Strains of the species are currently classified into five serogroups (A, B, D, E, F) based on capsular composition and 16 somatic serovars . ^[1][10]

P. multocida is the cause of a range of diseases in mammals and birds, including fowl cholera in poultry, atrophic rhinitis in pigs, and bovine hemorrhagic septicemia in cattle and buffalo. It can also cause a zoonotic infection in humans, which typically is a result of bites or scratches from domestic pets. Many mammals and birds harbor it as part of their normal respiratory microbiota.^[1][11]

Transmission

The transmition, of Pasteurella multocida, occurs via animal bites or scratches, furthermore the animal can transmit the bacteria without being ill (symptomatic) ^[2]

Diagnosis

Diagnosis can be made with isolation of Pasteurella multocida in a normally sterile site (blood, pus, or cerebrospinal fluid).^[12]

Diagnosis of the bacterium in humans was traditionally based on clinical findings, and culture and serological testing, but false negatives have been a problem due to easy death of P. multocida, and serology cannot differentiate between current infection and previous exposure. The quickest and most accurate method for confirming an active P. multocida infection is molecular detection using polymerase chain reaction.^[3][1]

• 
  Image indicate bronchodilation, centrilobular granular shadow, and consolidation
• 
  Chest radiograph
• 
  a)Frontal radiograph of the left knee demonstrates normal post-operative appearance of prosthesis with no prosthetic loosening b,c) computer tomography shows an abscess in front of knee prosthesis caused by Pasteurella multocida

Treatment

As the infection is usually transmitted into humans through animal bites, antibiotics usually treat the infection, but medical attention should be sought if the wound is severely swelling. Pasteurellosis is usually treated with high-dose penicillin if severe. Either tetracycline or chloramphenicol provides an alternative in beta-lactam-intolerant patients, however, it is most important to treat the wound.^[12][1]

History

Pasteurella multocida was first found in 1878 in cholera-infected birds. However, it was not isolated until 1880, by Louis Pasteur, in whose honor Pasteurella is named.^[13]

In animals

Sheep (can acquire Shipping fever)

P. multocida causes numerous pathological conditions in domestic animals, it often acts with other infectious agents, such as Mycoplasma species and viruses. Environmental conditions ( housing deficiency, and bad weather) also play a role.^[14][1][15]

These diseases are considered caused by P. multocida, alone or associated with other pathogens:

• Shipping fever in sheep ^[16] ("shipping fever" may also be caused by Mannheimia haemolytica, in the absence of P. multocida,^[17][18] and M. haemolytica serovar A1 is known as the most common cause of the disease.^[17] The pathologic condition commonly arises where the causative organism becomes established by secondary infection, following a primary bacterial or viral infection, which may occur after stress, e.g. from handling or transport.^[18])
• Enzootic pneumonia of sheep ^[19]
• Fowl cholera (chicken and other domestic poultry and cage birds)^[20]
• Enzootic pneumonia and atrophic rhinitis of pigs^[21]
• Pasteurellosis of rabbits^[22]
• Pasteurellosis is suspected to be the cause of recurrent mass mortality of Saiga antelopes.^[23]

See also

• Hemorrhagic septicemia
• Pasteurellaceae

References

External links