Pasteurellosis

Pasteurellosis
Classification and external resources
ICD-10	A28.0
ICD-9	027.2
MeSH	D010326

This page is about clinical aspects of the disease.  For microbiologic aspects of the causative organism(s), see Pasteurella multocida.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Danitza Lukac

Synonyms and keywords: Shipping fever; bovine respiratory disease complex; fibrinous pneumonia; pasteurella pneumonia; hemorrhagic septicemia; fowl cholera; snuffles

Overview

Pasteurellosis is an infection with a species of the bacterial genus Pasteurella, which is found in humans and other animals.

Pasteurella multocida (subsp. septica and subsp. 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 fulminant septicaemia (chicken cholera), but is also a common commensal.

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.

Historical Perspective

• The genus Pasteurella is named after the French chemist and microbiologist, Louis Pasteur, who first identified the bacteria now known as Pasteurella multocida as the agent of chicken cholera.

Pathophysiology

• The mechanisms of pathogenesis of Pasteurella infection in its natural host species and in humans are still not completely understood, and further studies are needed.
• Pasteurella is usually transmitted via the cutaneous route to the human host.
• Pasteurella uses a number of mechanisms for avoiding or suppressing bactericidal responses:
  • Lipopolysaccharides and the bacterias capsule probably play a substantial role in intracellular survival.
• Pasteurella needs iron to grow.
  • P. multocida has developed mechanisms acquire iron from hemoglobin, ferritin, lactoferrin and transferrin.

Types

There are several forms of the infection:

• Skin/subcutaneous tissue disease is a septic phlegmon that develops classically in the hand and forearm after 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.
• Sepsis is very rare, but can be as fulminant as septicaemic plague, with high fever, rigors and vomiting, followed by shock and coagulopathy.
• Pneumonia disease is also rare and appears in patients with some chronic pulmonary pathology. It usually presents as bilateral consolidating pneumonia, sometimes very severe.

Other locations are possible, such as septic arthritis, meningitis and acute endocarditis, but are very rare.

Causes

• Pasteurellosis is caused by an infection with Pasteurella spp.
• Pasteurella is a gram-negative, facultatively anaerobic bacteria.
• Pasteurella species are nonmotile and pleomorphic.
• Most Pasteurella species are catalase- and oxidase-positive.
• P. multocida is the most frequent causative agent in human.
• Pasteurella cells occur in many cats' mouths, a large percentage of dogs' mouths, and frequently in rabbits. This is in perfectly normal and otherwise healthy animals.
  • Cats oral cavity colonization of P. multocida is between 70%–90%
  • Dogs oral cavity colonization of P. multocida is between 50%–60%
• Less commonly, pasteurellosis can be acquired by inhalating the bacteria or with non known source of infection.
• Several reports describe human infections by Pasteurella spp. that were acquired after close contact with pets, including sharing a bed, being licked by, kissing the pets, animal scratches or bites.
• Pasteurella can be transmitted when exposed to animals that have been exposed directly or indirectly to the animals’ oropharyngeal secretions through licking or sniffing
  • P. multocida infection of a hip replacement site occurred in a 69-year-old man. This man indicated that the dog had shared his bed before and after his operations, sleeping under the covers on the side of the affected leg, as it had done every night.

Diagnosis

Diagnosis is made with isolation of Pasteurella multocida in a normally sterile site (blood, pus or CSF).

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.

See also

• Hemorrhagic septicemia
• Pasteurellaceae

External links

• Pasteurella multocida-related diseases in sheep and goats