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Breast implant infection is a potential complication after surgery. This case reports an unusual infection. A patient undergoes a skin sparing mastectomy for a carcinoma with an immediate breast implant reconstruction. Few days after, she consults for pain, erythema and fluctuating breast collection. The implant is removed and a lavage is done. Bacteriological cultures yield Pasteurella Multocida. She has close contact with cats. Her cat scratches a drain. It looks crucial to educate patients before they go back home. Correct postoperative cares and avoid pets are important to prevent complications.

Pasteurella multocida is generally responsible for local infections through animal bites. It can be a cause of meningitis, which tends to affect people at the extreme ages of life or suffering from immunodeficiency. A 14-year-old teenager was hospitalized with typical signs of bacterial meningitis. P. multocida was evidenced in the cerebrospinal fluid. Progression was marked by a degradation on the 4th day of treatment, despite intravenous antibiotic therapy with third-generation cephalosporin, followed by a single seizure on the 7th day of treatment. The CT scan and magnetic resonance imaging showed pansinusitis but no intracerebral complications. Later progression was favorable, without neurological sequelae. The mode of contamination was inoculation via the upper airways with sinusitis. P. multocida meningitis is rare. The contamination does not always involve animal trauma.

Une arthrite septique sur PTG est due essentiellement au Staphylococcus aureus suivie des staphylocoques à coagulase négative, et les streptocoques. Au cours de ses 40 dernières années très peu de cas d'infection sur arthroplastie à Pasteurella multocida ont été rapporté. La présentation clinique n'a rien de spécifique.la contamination survient après une morsure, griffure ou léchage d'un chat. L'interrogatoire et l'examen bactériologique est la clé du diagnostique. Nous rapportons le cas d'une patiente de 84 ans qui présente une infection a Pasteurella multocida suite à une morsure du chat 06 jours au paravent. Elle a bénéficié d'une prise en charge chirurgicale par lavage et synovectomie et une bi-antibiothérapie avec bonne évolution.

Pasteurella multocida is classically responsible for local soft tissue infections secondary to dog bites or cat scratches. It can be responsible for meningitis in infants and elderly persons. We report the case history of a 5-year-old male child admitted to our pediatric unit for meningitis. Cerebrospinal fluid analysis revealed an infection with P. multocida. The suspected mode of contamination was either from the saliva of a pet dog or through an unnoticed skull fracture sustained after an accident 1 year prior to the occurrence of meningitis. In spite of the neurologic complication (cerebral abscess), the progression was favorable after drainage of the abscess, 5 weeks of parenteral treatment, and 3 weeks of oral antibiotic therapy. Meningitis due to Pasteurella sp. is rare and can lead to neurologic complications. The notion of bites or scratches can be absent and the mode of contamination is sometimes difficult to unveil.

Pasteurella multocida is commensal of the normal nasopharynx or gastrointestinal flora in many domestic and wild animals. Cat and dog bites usually cause soft tissue infections. P. multocida is an unusual causative agent of meningitis which tends to affect neonates or aged patients. The authors report a case (a 93-year-old woman) of P. multocida meningitis induced by a cat bite with dramatic sequels leading to complete patient disability.

Vertebral osteomyelitis is a quite rare but severe cause of back pain in adults. Various causative organisms have been reported. Pasteurella species have rarely been isolated. We report here a case of vertebral osteomyelitis and consecutive cauda equina syndrome due to Pasteurella dagmatis in a 60-year-old diabetic man.

We report a case of lung infection caused by Pasteurella multocida in an immunocompetent patient. Diagnosis was made both on histological analysis of a lung wedge resection, showing pyoepithelioid granulomas, and on bacteriological cultures from lung tissue. Histological diagnosis of pulmonary pasteurellosis is difficult, and other etiological causes of pyoepithelioid granulomas of the lung have to be discussed. Pulmonary pasteurellosis is particularly severe in immunocompromised patients, and should be systematically suspected in patients exposed to pets, eventhough a percutaneous exposure is not usually found for these patients.

Healthy pets contact are able to induce unusual and severe diseases.This case reports the medical history of a dorsal spondylodiscitis in a diabetic patient admitted for a chronic wound of his toes. He had a long-standing history of regular consumption of alcohol and tobacco. Blood bottles and biopsy of intervertebral disc infected discovered Pasteurella dagmatis, commonly colonizing the oropharynx of healthy dogs and cats. In this case, licking of his injured toe by his dog was the likely source of entry of the organism.We found no identical cases in the medical literature. Diabetes mellitus and other immunocompromised disorders justify to change behaviours toward domestic animals.

Pasteurella multocida is a rare cause of meningitis. We report a case of P. multocida meningitis following a recent neurosurgery procedure and review the 32 cases previously described.

Bacteremic pasteurellosis is an uncommon form of Pasteurella multocida infection, usually involved in local infections. This systemic infection often occurs in immuno-compromised patient such as cirrhotic or alcoholic patients, with a high mortality rate (up to 60%). Septic shock may occur and neurological disorders or coma are frequent. We report such a case. Treatment associated local care, antibiotics (beta-lactam antibiotics plus fluoroquinolone) during 14 days and resuscitation of septic shock. Owing these therapies, septic shock was successfully treated without complications.

Human pasteurellosis is, in general, a locoregional infection due to contact with an animal. Systemic infections are rare and endocarditis is exceptionally described. The authors report two new cases of endocarditis due to Pasteurella spp, they then review 29 other published cases. Pasteurella spp. endocarditis presents as an acute form in 64% of cases and affects the aortic as often as the mitral valves. Contact with an animal is documented in 65% of cases. Pasteurella multocida is the most frequent species in this infection. The total death rate is 40% and can reach 57% of cases in case of immunodepression. The bad prognosis of this infection, justifies an early diagnosis and a rapid and adapted but not yet consensual medicosurgical treatment.

We report the first case of Pasteurella multocida meningo-encephalitis with aphasia in a 28 year-old-patient. The investigations confirmed the diagnosis of bacterial meningitis. But the delay in identification of the organism involved iterative changes of antibiotherapy. The evolution was finally favourable with appropriate antibiotic treatment. The epidemiologic investigation highlighted the responsibility of a patient's cat carrying the same bacterial strain. Finally we discuss the epidemiologic, clinical and therapeutic features of this unusual meningitis.

Pasteurella multocida is usually responsible for local infections occurring after animal bites. It can also be responsible for meningitis in infants. A three-month old infant was admitted to hospital with a diagnosis of bacterial meningitis and hip osteitis. Cultures of cerebrospinal fluid, blood and joint liquid were positive to Pasteurella multocida. Licking from the family dog was the transmission mode in this case. Despite initial neurological complications, clinical evolution was favourable after three weeks of intravenous antibiotic therapy followed by an oral administration for three months. Pasteurella multocida meningitis is rare in infants. It can be associated with arthritis, osteitis and septicaemia. Besides animal bites, licking is also a mode of contamination.

The circumstances of diagnosis of human pasteurellosis are reviewed. The diagnosis is usually suspected for animal bite or scratch wounds. Conversely, in other infections the diagnosis is only based on bacteriological data. Phenotypic misidentification of Pasteurellaceae from clinical material is common. The phenotypic criteria of identification of the six species of human pathogen Pasteurella are presented. We emphasise that bite wound specimens have to be cultured for aerobic and anaerobic bacteria and yield an average of 5 bacterial isolates per culture. Antibiotic therapy relies upon amino-penicillins or cephalosporins, although b-lactamase producing strains are scarce. Fluoroquinolones can be an alternative for systemic infections. Molecular typing unequivocally points out the risk of transmission from pets to humans. Immunocompromised persons have to be made aware of precautions.

Doxycyclin is a semi-synthetic structural isomer of the tetracycline family. It exhibits good intra-cellular penetration, with bacteriostatic activity on many bacteria. Different types or bacterial resistance are known. Acquired resistance has a ribosomal or a plasmidic mechanism. Resistance of Propionibacterium acnes is secondary to a mutation of ARNr. Doxycyclin also has an anti-inflammatory activity, via numerous pathways. Doxycyclin is rapidly and almost completely absorbed by the digestive tract. Food has no incidence on the absorption. It has a high but labile affinity for proteins with 90 p. 100 of the molecule linked. It rapidly diffuses in the extravascular compartment and in most of the tissues. Bile excretion is the main excretion route. It occurs more slowly by the kidney with tubular reabsorption. The main dermatological indication is acne with daily dose varing between 50 mg and 100 mg. Although good assays are lacking, a large professional consensus has validated its use. It is also active at the same dosage in rosacea. Chlamydial and mycoplasma urethritis may be treated by doxycyclin, and this antibiotic is presently used as second choice. Many other diseases may be treated as a primary or secondary choice, such as treponematoses, brucellosis, pasteurellosis, borreliosis, rickettsioses and cholera. Some non infectious diseases have been occasionally treated by doxycycline. Digestive side effects are the more frequent. Esophageal toxicity has been reduced with tablets and sufficient concomitant water ingestion. Phototoxicity is dose-dependent. Various cutaneous side effects have been described, some of them severe. Systemic toxicity is rare. Pregnancy is a contra-indication, and as other tetracyclines, it should not be given to children and during lactation. Doxycycline is commercialized as tablets. No reduction of the dose is necessary in renal failure. Association with retinoids is not recommended. Anticoagulants are potentialized. Didanosin, iron, and mineral salts lower its activity.

Pasteurella multocida septicemic septic shock without scratches in chronic alcohol abusers are rare and paucibacillar. Chronic legs ulcers could be predisposing factors. Three severe cases of such diseases with early multiple organ failure without endocarditis despite 3, 5 and 3 positive blood cultures respectively are reported.In all three cases, the source of septicemia was extensive skin legs ulcers contaminated by domestic cat saliva, probably. The underlying diseases were alcoholism, without cirrhosis (2 cases) and with cirrhosis (1 case). Aggravating factors were present (chronic renal insufficiency, diabetes mellitus, non-steroidal anti-inflammatory agents) and they might have been responsible for pejorative outcome despite early appropriate empirical antibiotic regimens.Because P. multocida SSC could be fulminant in chronic alcohol abusers with or without cirrhosis, we propose for these patients reducing exposure to cats and hand-washing after exposure if wounds are present.

We report a case of a lung abscess due to Pasteurella multocida, isolated from bronchial secretions by fiberoptic bronchoscopy. Antibodies against Pasteurella multocida were elevated in the patient, and absent in controls (including the patient's wife). The identity of the strain isolated in the patient and that in his cat was proved by molecular method using pulsed field gel electrophoresis.

Pasteurella multocida is a major pathogen in local wound infections due to animal bites. Pneumonia and bacteremia are less frequent and usually associated with local or general impairment of host defenses. Scarce reports exist about Pasteurella multocida infections in HIV infected patients. We report here a case of hypoxemic pneumonia and bacteremia due to Pasteurella multocida revealing an HIV infection in a young man.

Pasteurella multocida pneumonia mainly occurs in immunodepressed patients. Microbiological proof is difficult to obtain.A 36-year-old woman with systemic lupus erythematosus treated with cyclophosphamide and corticosteroids developed pneumonia. She was given amoxicillin-clavulanate. Bronchioalveolar lavage fluid cultures on gelose were negative but Pasteurella multocida grew on blood culture medium.Although the direct examination of bronchioalveolar lavage fluid demonstrated Gram negative coccobacilli, gelose cultures were negative, probably because of prior antibiotic therapy. The causal pathogen was only identified when BAL fluid was seeded on blood culture medium, allowing susceptibility tests and subsequent early adaptation of antibiotic therapy. This technique can be helpful in identifying the casual pathogen in microbial pneumonia.

Materno-fetal infection due to Pasteurella multocida is rare; it may be severe in the neonate.A 27-year old woman was admitted at 37 weeks' gestation with a history of abdominal cramps. Twenty-four hours after delivery, the mother was febrile (40 degrees C) and was given intravenous cefotaxime (2 days), followed by cefpodoxime (15 days). The newborn was febrile and hypotonic 24 hours after birth; he received an infusion of hydroxyethylamidon and was given cefotaxime (3 days), netilmicin (6 days) and amoxicillin (10 days). Pasteurella multocida was isolated from placenta, blood and gastric fluid in the baby and in blood cultures and vaginal swab in the mother. It was established that the mother was bitten by her dog during the pregnancy and wounded a few days before delivery.This neonate was infected during the delivery and the source of mother's contamination was easy to determinate: pet animals were kept by the family and there was an history of wounds during her pregnancy.

Epizootic pasteurellosis appeared in a semi-intensive breeding farm (200 animals) of indigenous rabbits in Thiès (ENSA), Senegal, during the 1995 wet season (August to October). It provoked death in 87 animals. Young animals were particularly sensitive to the disease. Nasal discharge, conjunctivitis, eye loss and otitis media and interna were observed in young rabbits while posterior paresis was noted in mature rabbits. Pasteurella multocida, Klebsiella pneumoniae and Pseudomonas aerogenes were identified. An antibiogram revealed the germs were sensitive to chloramphenicol, sulfamethoxazole/trimethoprim and colistin. High temperatures and humidity during the wet season may have contributed to the outbreak of the disease from healthy carriers introduced at the founding of the farm. Colistin and chloramphenicol treatments were administered before vaccinating all rabbits against pasteurellosis.

The purpose of this study was to compare the efficacy of Mycoplasma hyopneumoniae vaccination with pulse medication in a pig herd chronically infected with Mycoplasma hyopneumoniae. Control groups of pigs were compared to vaccinated or treated groups. Medication and vaccination induced a significant reduction of pneumonia score (46.37% and 29.8% respectively, compared to 53.85% for control groups, p0.05). The treatment did not induce a significant reduction of the mean range of lung lesions (3.75) compared to the control groups (4.25). The mean range of lung lesions was significantly reduced by vaccine (3.06, p0.005) but not by treatment. Neither the medication nor the vaccination were able to clear M hyopneumoniae or Pasteurella multocida from lung tissue. In this herd, the vaccination had a beneficial effect on daily weight gain of pigs (695.9 g/day compared to 683.1 g/day for the control groups). The improvement of the age at slaughtering was 1.3 days for treated groups and 2.4 days for vaccinated groups compared to control groups. The vaccination induced a significant improvement in muscle rate (57.05%) compared to control groups (56.41%, p0.05) and to treated groups (56.21%, p0.001). In this herd infected with M hyopneumoniae, after allowing for treatment cost, manpower excepted, the increase in value was from -3 FF to -11 FF for the antibiotic treatment and +10.4 FF for the vaccination. From economical and medical points of view, the vaccination was preferable to the treatment under the conditions described in this study.

According to the genetic relationships among Gram-negative bacilli the genus Pasteurella is included with the genus Haemophilus and the genus Acinobacillus within the family Pasteurellacae. Pasteurella multocida, the type species, is responsible for the majority of human Pasteurella infections. P. multocida is a member of the normal flora in the upper respiratory tract of many mammals or birds. It causes sporadic or epidemic diseases among different animal species, particularly pneumonia and atrophic rhinitis in swine in intensive breeding stations. The most common human infection with P. multocida is a local cellulitis following dog or cat bites and scratches. Serious local complications are sometimes responsible for prolonged disability. The respiratory tract is the second human source of P. multocida isolates. The frequency of recovery of P. multocida from oropharynx of apparently healthy pig breeders suggests that respiratory pasteurellosis could be an occupational disease. The mechanisms of virulence of P. multocida are unclear. Several factors are involved: capsules preventing phagocytosis, a dermonecrotic toxin causing experimental atrophic rhinitis, hyaluronidase, neuraminidase and proteases. Penicillin is considered to be the drug of choice for Pasteurella infection. Tetracyclin is efficient for bites but has no bactericidal effect. Oxacillin, first-generation cephalosporins, macrolides and aminoglycosides have poor activities. In the case of beta-lactamase producing strains a bactericidal effect could be achieved with fluoroquinolones or third generation cephalosporins.

For the first time in Cameroon, a strain of Pasteurella multocida serotype B6 was isolated from a haemorrhagic septicaemia outbreak in Zebu cattle in the area of Maga (Far Northern Province). Through the mouse protection test, evidence was given that there was no cross protection between this strain and the strain of Pasteurella multocida serotype E6 which is used as an inactivated vaccine in Cameroon. Hence, it is recommended to use a combined vaccine including both serotypes for the Central and West African countries.

We observed two cases of Pasteurella and discuss the role of bacterial sampling in ulcerations of the lower limb.In the first case, Pasteurella was discovered in an ulceration of the lower limb and was cured with no particularly specific care. In the second case, Pasteurella had been inoculated by scratching an ulceration and could not be cured without specific treatment.No specific pathological consequence in chronic carriers could be possible, a situation which has often been reported in the literature. Pasteurella is an unusual specific cause of ulcerations of the lower limb.

A case is reported of an 18-year-old male patient who had a road traffic accident, with head and chest injuries. The patient was admitted to the surgical intensive care unit 24 h later because of an alteration of his level of consciousness. He required artificial ventilation. Five days later, he developed right-sided lower lobe pneumonia, treated with positive end-expiratory pressure. A Gram negative organism was found on bronchial brushing, but not in haemocultures. It was identified as Pasteurella multocida, sensitive to beta-lactamines, but not to amikacin. Cefotaxime, which had been started immediately after the arrival of the Gram stain result, was continued. Artificial ventilation was discontinued on day 12, and the patient left the unit on day 15. The patient was probably a P. multocida carrier, being in close contact with animals before his accident. This bacteria is often found in infected animal bite wounds. Pneumonia due to this bacteria usually occurs in immunodepressed patients, which was not the case here.

The authors describe three cases of patients who had previously undergone a pneumonectomy (two for cancer, one for bronchiectasis) with a favourable postoperative course, who subsequently developed pyothorax in the thoracic cavity. The bacteria isolated where in the first patient, Pasteurella Multocida; in the second, Campylobacter foetus foetus; in the third, a variety of anaerobic organisms. The characteristic of the organisms allow us to exclude the possibility that these cases of pyothorax were due to a contamination during the operation, in favour of transient bacteraemia with contamination of the fluid of the thoracic cavity. In a patient who has undergone pneumonectomy (as in patients with a joint or valve prosthesis) it is important to avoid (or to treat early) any infections which could give rise to bacteraemia, especially dental infections.

Pasteurella are common bacteria among healthy animals. Humans usually are infected by dog and cat bites or scratches. Besides, local skin infection, Pasteurella may spread, in some cases, to lungs, joints, bones or, less frequently, to other organs.

A serological survey on avian pathology in a village area was carried out in Niger. It allowed to determine the incidence of pullorosis (47%), pasteurellosis (48%), avian bursal disease (47%) and Newcastle disease (14% in non vaccinated and 63% in vaccinated animals).

The discovery of the role played by somatic antigens of the Pasteurella multocida A and D capsular types in the immunization of susceptible species makes it necessary to type the somatic antigens of the isolated strains prior to any action to induce active or passive immunity. Only immunoprecipitation in gel was chosen out of the various typing techniques proposed, and a correlation was established between the capsular types (according to Carter), somatic types (according to Namioka) and types determined by immunoprecipitation in gel (according to Heddleston). Parallel to this, the same technique was developed for strains of Pasteurella multocida B and E capsular types, and the immunogenicity of these capsular antigens was proven.

Although bone and joint infections do not seem to be more frequent in patients with immune deficiences than in normal subjects, it seems paradoxically that an immune deficiency is relatively frequent during fully diagnosed bone and joint infections : the discrepancy between the two types of data is not easy to explain. Serology and immunology laboratories give little information in the etiological diagnosis of bone and joint infections, with the exception of perhaps gonococcal infections (search for anti-gonococcal antibodies by immunofluorescence). staphylococcal infections (pasteurella, yersinia, tularemia and brucella infections). In most cases, although the abnormalities observed are due to infection of the organism by the germ, they have nothing characteristic of the bone and joint localisation itself.

A seventy-seven-year-old woman, under intermittent treatment with chlorambucil for chronic lymphocytic leukemia, developed acute pneumonia (diffuse interstitial pneumonitis) due to Pasteurella multocida. No direct traumatism had been caused by her cat. Bacteriologic study material was obtained by guided transtracheal distal bronchial brushing and washing. Therapy with tetracyclin was rapidly successful. Pasteurella multocida is an opportunistic organism which can be responsible for severe infections in high-risk patients.

Authors report a Pasteurella Multocida corneal abscess after a scratch from a cat. The evolution was torpid and needed a transfixiant keratoplasty. They recall bacterial tanks, infestation ways, clinical manifestations and bacteriological identification. They note the low occurrence of ophthalmological manifestations and the sensibility of Pasteurella to various antibiotics, especially Beta lactams, phenicol and cyclins.