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PubMed1999

Pasteurella multocida meningitis in infancy - (a lick may be as bad as a bite).

UNLABELLED: Pasteurella multocida is the commonest cause of local infection after an animal bite, but is an unusual cause of meningitis. We report a case of P. multocida meningitis occurring in a 7-week-old infant which was contracted after non-traumatic contact with a household pet, that is, without any animal bite or scratch. The organism may be easily confused with more common Gram-negative pathogens. In this case, it was initially incorrectly diagnosed as Haemophilus influenzae type b (Hib); a possibility which has important implications in the era of routine use of Hib vaccine in infant immunisation programs. CONCLUSION: Pasteurella multocida is an unusual, but serious cause of meningitis in infancy. It is potentially preventable by the avoidance of contact between young infants and the saliva of household pets, in particular by assiduous hand hygiene.

Animals↗
PubMed1999

Allergies and vocal fold edema: a preliminary report.

This paper describes different tools to rule out the etiology of vocal fold edema. A complete voice assessment is used in our Voice Center. This includes patient history, acoustic analysis, laryngeal video-stroboscopy, otolaryngology consultation, allergy testing from our Allergy Clinic, and gastroenterology consultation as appropriate. Inhalant allergy can be a hidden, yet very common cause of chronic laryngitis. Respiratory allergies can also cause decreased pulmonary function; excessive secretions in either the lower airway, trachea, bronchi or in the upper airway of the pharynx; edema of the vocal folds themselves; and unusual resonance characteristics of the pharynx or nasal cavity due to congestion of the membrane in those areas. Voice patients with a history of seasonal hay fever, a history of allergic reactions around cats or dogs, or a strong family history of allergies should be allergy tested. Screening tests for allergies are available, which include a screening radioallergosorbent test or a screening panel of scratch or intradermal skin tests. Once specific allergens are identified, recommendations for therapy or other intervention can be made. Straining the voice, in combination with the above conditions, can increase the voice problem. The histories, allergy test results, and voice laboratory evaluations of several patients are described. Identifying these voice patients and treating their allergies are important in keeping these patients healthy and maintaining a clear, good voice quality. The multidisciplinary approach in voice disorders is indispensable in diagnosis and treatment of these disorders.

Adult↗
PubMed1996

Mass human exposure to rabies in New Hampshire: exposures, treatment, and cost.

OBJECTIVES: This study assessed the rabies exposure and treatment that at least 665 persons in Concord, NH, received as a result of one proven rabid pet-store kitten in October 1994. METHODS: All treatment recipients were interviewed by person or phone. RESULTS: The median age of the treatment recipients was 14 years; 58% were female. The most common exposures were low risk (e.g., picking up, petting, nuzzling, or being scratched by a potentially rabid kitten). Local reactions to vaccine or immune globulin were reported by 76.5% of recipients, while 48.8% reported at least one systemic reaction. Cost for the biologicals was estimated at more than $1.1 million. CONCLUSIONS: Because of the inadequacy of pet store records, the inconsistent application of treatment guidelines, and other factors, many people received postexposure treatment as a result of contacts that were unlikely to transmit rabies. The rates of local and systemic adverse reactions experienced were consistent with previous reports.

Adolescent↗
PubMed2004

Pasteurella multocida septicemia caused by close contact with a domestic cat: case report and literature review.

We report here a case of Pasteurella multocida infection caused by cat exposure presenting with septic shock, sinusitis, and pneumonia. The patient was a febrile 20-year-old woman who had been experiencing disturbed consciousness progressively. She had close contact with a domestic cat and had received some scratches on both arms. A magnetic resonance imaging (MRI) scan of the head showed a high intensity in the paranasal cavity, and a computed tomographic (CT) scan of the chest showed bilateral lung consolidations. The pathogen was identified as P. multocida by the cultures from blood and nasal discharge. She was given intensive antibiotic therapy with ceftriaxone and piperacillin, continuous hemodiafiltration (CHDF) therapy, and anticoagulation therapy. Owing to these therapeutic regimens, the septic shock was successfully treated without complications. We also review the literature on P. multocida septicemia.

Adolescent↗
PubMed1994

[Food allergy in dog and cat].

Food allergy in the dog or cat can only be described as non-seasonal dermatitis accompanied by scratching. When the term 'food allergy' is used, an immune-mediated reaction is not always meant, although the term would suggest that it is. The frequency of occurrence of food allergy is unknown, with the literature giving widely differing percentages. Type I and type IV hypersensitivity reactions probably play a role in the pathogenesis, although a type III reaction is also thought to be involved. Gastrointestinal disturbances and skin complaints are symptoms of food allergy, and scratching is nearly always mentioned as the most common sign. The diagnosis can only be made by feeding the animal on a hypoallergic diet, which must be given for several weeks. Diagnostic tests are unreliable. The patient should not have been previously exposed to the ingredients of the hypoallergic diet. As 'home-made' diets may be deficient in minerals, vitamins, and essential amino acids, these ingredients must be supplemented if the diet is to be maintained for a long time. The prognosis of food allergy is good if the causative ingredient is identified. It is important the animals' owner is given through instruction. Medicines have little effect on food allergy.

Animals↗
PubMed2003

Feline orthopoxvirus infection transmitted from cat to human.

We report the case of a 56-year-old female patient who presented with an inflamed, ulcerated lesion on the left side of her neck after contact (scratch) with a cat living in the patient's house. Satellite lesions developed despite local treatment and parenteral clindamycin. Histopatholgic examination and the Tzanck test showed evidence of a viral infection. Subsequent transmission electron microscopy of scrap tissue and material from a fresh pustule exhibited multiple typical poxvirus particles, predominantly in remnants of scaled-off layers of degenerated keratinocytes, and virus particles in intermingled phagocytes, leading to the diagnosis of feline Orthopoxvirus (cowpox virus) infection. These results were verified by polymerase chain reaction and sequencing. Concern has been raised as to whether discontinuation of smallpox vaccine would cause an increase in Orthopoxvirus infection, but this has not yet shown to be the case.

Acyclovir↗
PubMed1996

Exposure to domestic cats: risk factor for Pasteurella multocida peritonitis in liver cirrhosis?

Pasteurella multocida is most commonly associated with acute skin and soft tissue infections following an animal bite or scratch. Peritonitis caused by P. multocida in patients with cirrhosis is rarely reported. We present a case of spontaneous bacterial peritonitis with P. multocida in a patient with cirrhosis, squamous cell cancer of the head and neck, and nontraumatic domestic cat exposure. Nasopharyngeal colonization with P. multocida, with subsequent transient bacteremia and seeding of the peritoneum in immunocompromised (particularly cirrhotic) cat-owners, could play an important pathogenetic role in the development of spontaneous bacterial peritonitis. A review of the literature showed that in nine of 13 patients with cirrhosis and P. multocida peritonitis, exposure to domestic animals was reported. The mortality rate is high in this setting, even with prompt antibiotic treatment. Preventive strategies for immuno-compromised patients should include minimization of animal contact, especially cats, which have a high carriage rate (70-90%) of P. multocida.

Aged↗
PubMed2000

Cases of cat-associated human plague in the Western US, 1977-1998.

Exposure to cats infected with Yersinia pestis is a recently recognized risk for human plague in the US. Twenty-three cases of cat-associated human plague (5 of which were fatal) occurred in 8 western states from 1977 through 1998, which represent 7.7% of the total 297 cases reported in that period. Bites, scratches, or other contact with infectious materials while handling infected cats resulted in 17 cases of bubonic plague, 1 case of primary septicemic plague, and 5 cases of primary pneumonic plague. The 5 fatal cases were associated with misdiagnosis or delays in seeking treatment, which resulted in overwhelming infection and various manifestations of the systemic inflammatory response syndrome. Unlike infections acquired by flea bites, the occurrence of cat-associated human plague did not increase significantly during summer months. Plague epizootics in rodents also were observed less frequently at exposure sites for cases of cat-associated human plague than at exposure sites for other cases. The risk of cat-associated human plague is likely to increase as residential development continues in areas where plague foci exist in the western US. Enhanced awareness is needed for prompt diagnosis and treatment.

Adolescent↗
PubMed1990

Recent data on the epidemiology and prophylaxis of human rabies in France.

Rabies is an animal disease which is transmitted to man only by accident, most often through the bite (more rarely after scratches or licks of mucosa) of a rabid animal, domestic or wild. A good knowledge of the epizootiology of animal rabies is therefore necessary to establish, on solid grounds, the prophylaxis of human rabies. Inter-human transmission of rabies being an exceptional event which will be considered separately, the epidemiology of human rabies mainly studies the sources and circumstances of human exposure to rabid animals, which differ according to the epizootiology of animal rabies in a given country: either enzootic (or hyperenzootic) canine rabies, or enzootic selvatic rabies. It appears that the risk of human rabies is higher in the first situation for two reasons: (i) rabies viruses show an increased virulence due to numerous serial passages in dogs (viruses with short incubation period) and (ii) high frequency of dog-man contacts due to the high density of both populations.

Animals↗
PubMed2005

Primary conjunctival sporotrichosis: two cases from a zoonotic epidemic in Rio de Janeiro, Brazil.

PURPOSE: To describe Sporothrix schenckii conjunctivitis in 2 owners of cats with sporotrichosis. METHODS: Small case series and literature review. RESULTS: Two women had been caring for their pet cats with sporotrichosis for 2 months but did not recall any traumatic injury such as scratches or bites. Each presented a conjunctival granulomatous lesion measuring 4 to 5 mm accompanied by local hyperemia, secretion, and edema, in addition to painful facial subcutaneous nodes and regional lymph node enlargement. Pyogenic material was collected from the conjunctival sac and from cutaneous lesions on the cats. In both the patients and their respective cats, fungal colonies were isolated and identified as S. schenckii. Treatment with oral itraconazole 100 mg/d for 3 months resulted in complete healing of lesions in both patients. Patients remained clinically cured 15 months after end of treatment. CONCLUSION: Sporotrichosis is presently occurring as an emerging zoonosis in Rio de Janeiro, and some unusual clinical forms have been diagnosed in humans. The cases reported here suggest atraumatic exposure to cats infected by S. schenckii.

Adult↗
PubMed1995

[Toxocariasis. A cosmopolitan parasitic zoonosis].

The infection by Toxocara canis transmitted by dogs (30% of them are infected in our countries) and less frequently by cats lead to larva migrans visceral syndrome with neurological manifestations, ophtalmological affection and various cutaneous manifestations observed in 24% of the extra-ocular infections: chronic urticaria often associated with asthmatic manifestations and chronic rhinitis, angio-oedema or local oedema reaching particularly the eyclid, chronic pruritus associated with lesions due to scratching or to nodular prurigo. An hypereosinophilia is an argument in favour of a progressive infection. High total IgE is an hallmark of visceral infections by parasites and total IgE level is well correlated with the presence of intra-tissular larva. The serological diagnosis is based on the determination of specific IgG by ELISA which appears also to be interesting for the patient's follow up. The western blot method seems to be more specific than the other methods and so is useful to confirm a diagnosis. The treatment given as early as possible is based on the use of diethylcarbamazine but also of thiabendazole, albendazole and mebendazole. Prophylaxis of toxocara infection includes the prohibition of dog access to children games areas but also a frequent turn over of the sand in public parks.

Animals↗
PubMed2000

Declawing of neonatal rabbits destined for use in animal biosafety level 4 containment studies.

To protect personnel and protective outerwear from damage by scratching, rabbits to be housed in an Animal Biosafety Level 4 (ABSL4) facility are declawed routinely. The objective of the study presented here was to establish a procedure for declawing all four feet of neonatal rabbits in preparation for use in ABSL4 studies. Combining procedures conducted in private veterinary practice to remove dewclaws of canine pups with those used to declaw cats, we declawed rabbit kits at 3 to 8 days of age. Declawing neonates was believed to be advantageous because they are non-ambulatory, have soft, cartilaginous digits, and do not have extensive hair growth. These features resulted in decreased surgical preparation and surgery time, minimal bleeding, and minimal aftercare. The optimal age for declawing a litter was 6 or 7 days. Declawing of neonatal rabbits is relatively simple and efficient to perform and offers advantages over declawing of older animals. By using the method described, rabbits can be introduced into ABSL4 facilities by 12 weeks of age with confidence that nail regrowth will not occur.

Animals↗
PubMed1990

Bartonella bacilliformis stimulates endothelial cells in vitro and is angiogenic in vivo.

Bartonellosis, a biphasic disease caused by motile intracellular bacteria, produces in its tissue phase a characteristic dermal eruption (Verruga peruana) resulting from a pronounced endothelial cell proliferation. Bacteria are found in the interstitium and within the cytoplasm of endothelial cells (Rocha-Lima inclusion). The aim of this study was to determine if Bartonella bacilliformis produce a substance(s) that might be responsible for the vascular proliferation seen in the Verruga. This was assessed in an in vitro system using human endothelial cells and measuring proliferation as well as production of tissue type plasminogen activator after exposure to the endothelial cultures to B. bacilliformis extracts. Our results indicate that B. bacilliformis possess an activity that stimulates endothelial cell proliferation up to three times that of control. The factor(s) is specific for endothelial cells, heat sensitive, larger than 12 to 14 kd, not enhanced by heparin, has no affinity for heparin, and is precipitated by 45% ammonium sulfate. In addition, the B. bacilliformis extracts stimulate production of t-PA antigen in a concentration-dependent fashion. This activity is also heat sensitive and not lost after dialysis (12 to 14 kd). B. bacilliformis extracts, however, do not increase the production of plasminogen activator inhibitor. It was also determined that B. bacilliformis extracts stimulate the formation of new blood vessels in an in vivo model for angiogenesis. These results describe a bacterial factor(s) that stimulates two important steps in the development of new blood vessels in vitro, as well as the formation of new blood vessels in vivo. Determining the mechanism of action, combined with a complete characterization of this factor(s), may help in understanding the pathogenesis not only of the Verruga and angiogenesis in general but also the recently described Cat-Scratch-associated epithelioid hemangiomas in patients with AIDS and Kaposi sarcoma.

Animals↗
PubMed1995

Pasteurella multocida isolation from a tuboovarian abscess. A case report.

BACKGROUND: Human infection with Pasteurella multocida occurs most commonly following a nonhuman animal bite wound or cat scratch, with local skin and soft tissue infections the most frequent posttraumatic manifestations. Genitourinary tract pathology attributable to this organism occurs infrequently, with only one previous reported case of P multocida infection presenting in the form of a tuboovarian abscess. CASE: A 44-year-old woman with an acute abdomen underwent exploratory laparotomy, revealing a right-sided tuboovarian abscess. Following a total abdominal hysterectomy and bilateral salpingo-oophorectomy with a seven-day postoperative course of intravenous metronidazole, ampicillin and gentamicin, the patient was sent home on a regimen of cephradine, only to return with sepsis three days later. A course of intravenous aqueous penicillin sodium, metronidazole and cefotaxime was administered for the treatment of P multocida sepsis since this organism was identified in the intraoperative pelvic fluid culture 24 hours after the patient's initial discharge. After 13 days of the above regimen, the patient achieved full defervescence and was discharged on hospital day 15. CONCLUSION: In the setting of a tuboovarian abscess, the clinician should consider P multocida as a potential etiologic agent, especially in a patient with extensive exposure to nonhuman animals. In the treatment of an acute adnexal infection secondary to this organism, one should employ perioperative therapy with the appropriate antibiotics for a duration of at least 14 days.

Abscess↗
PubMed1990

[Human respiratory tract infection by Pasteurella multocida subsp. multocida presumably derived from the cat].

Pasteurella multocida is a Gram-negative short rod-shaped bacteria that has been recognized as a pathogen of hemorrhagic septicemia and fowl cholera in the veterinary medicine. Infections by this microorganism as seen in the foreign literature vary widely from local infections due to bites and scratches by animals to general infections such as infections of the respiratory tract, sepsis, and meningitis. In Japan, reported cases of P. multocida infections are predominantly local infections, followed by respiratory infection. Recently, death of diabetic patients due to septicemia by this pathogen has also been reported. In this study, we experienced a case of respiratory tract infection in which the pathogen P. multocida subsp. multocida was suggested to have been transmitted from a pet cat by the agreement of the serotype of the bacterial isolates between the patient and the cat. This case was evaluated from the zoonotic viewpoint. The patient was a 68-year-old male who had been followed up since 1982 with a diagnosis of bronchiectasis. After his referral to our hospital, P. multocida subsp. multocida was isolated from his bloody sputum and, then, from the cat kept by the patient. The tow isolates were identical in terms of the biochemical properties, drug susceptibility profile, and serotype (-:1), and the derivation of P. multocida subsp. multocida infection from cat was established for the first time in this report. The incidence of P. multocida infections is increasing in Japan, and particular attention is considered to be needed about these conditions as zoonoses as indicated in "Preventive Measures against Zoonoses Derived from Pet Animals (Dog, Cat)", an official communication from the Ministry of Health and Welfare to related institutions in 1989. Also, to check whether the patient keeps any pet at the clinical inquiry is a practice of bacteriological importance in all fields of medicine.

Aged↗
PubMed1995

[Interstitial pneumonia and sepsis due to a Pasteurella multocida infection].

HISTORY AND CLINICAL FINDINGS: A 65-year-old diabetic (requiring insulin during the last year) was admitted as an emergency because of a septic temperature rising to 40 degrees C with rigor, tachycardia (up to 120/min) and dyspnoea. On examination there was local reddening and swelling of the skin over the right thenar eminence and along the lower arm. Two days before admission a bad scratch had been inflicted on his right hand by a cat. He had first noticed the reddening and swelling 10 hours after the incident; 1 1/2 days after the scratch and 9-10 hours before hospitalization the first bouts of fever had occurred. EXAMINATIONS: The chest radiogram showed interstitial pneumonia. The clinical findings, the laboratory tests (white cell count 21 750/microliters, platelets 140,000/microliters, C-reactive protein 35 mg/l and positive blood cultures pointed to early septicaemia. The germ was identified as Pasteurella multocida two days after blood had been taken for culturing. HbA1c was 11.38%. TREATMENT AND COURSE: From the time of hospitalization the patient had been treated with ceftriaxon, 2 g daily intravenously, and also with erythromycin because atypical pneumonia had been the suspected diagnosis at first and acute chlamydia infection had at first not been excluded. The patient's general condition quickly improved and the fever started to go down a few hours after onset of treatment. Blood cultures became negative after the first administration of antibiotics. He was discharged in a good state on optimal insulin dosage. CONCLUSION: Pasteurella multocida is present in a high percentage of domestic animals and can be the cause of systemic infections in immunocompromised patients (e. g. poorly controlled diabetes mellitus).

Aged↗