Pasteurella multocida. Key words: Pasteurella multocida, Septicemia, Pleuritis and Pericarditis

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1 Pasteurella multocida Key words: Pasteurella multocida, Septicemia, Pleuritis and Pericarditis

2 Fig. 1 Clinical Course CLDM: clindamycin

3 chloramphenicol (CP), tetracycline (TC), MINO, kanamycin (KM), gentamicin (GM), amikacin (AMK), ABPC, carbenicillin (CBPC), piperacillin (PIPC), cephaloridine (CER), CEZ, cefoxitin (CFX), CTX, cefoperazone (CPZ), colistin (CL), nalidixic acid

4 # Table 1 Chemotherapeutic susceptibility of Pasteurella multocida S: susceptible, R : resistant, : 100% susceptible, : Sulfonamide, Sulfamethoxazol-Trimetoprim

5 8) Frutos, A. A., Levitsky, D., Scott, E. G. & Steele, L.: A case of septicemia and meningitis in an infant due to Pasteurella multocida. J. Pediatr., 92: 853, ) Nadler, J. P., Freedman, M. S. & Berger, S. F.: Pasteurella multocida septicemia. N.. State j. Med., 251: , ) Omar, M. A. K., Dayal, B. & Appelbaum, P.C.: Pasteurella multocida septicemia complicating Med., 256: , ) Debore, R. G. & Damler, M.: Pasteurella multocida infections: A rport of six cases. Am. J. Clin. Pathol., 40: , ) Schmidt, E. C. H., Truitt, L. D. & Kogh, M. L.: Pulmonary abscess with empyema caused by Pasteurella multocida: Report of a fatal case. Am. J. Clin. Pathol., 54: , ) Lewis, M. L.: Fatal menigitis with septicemia caused by Pasteurella multocida. Am. J. Clin. Pathol., 23: 241, ) Normann, B., Nilehn, B., Rajs, J. & Karlberg, B.: A fatal human case of Pasteurella multocida septicemia after cat bite. Scand. J. Infect. Dis., 3 : , ) Heyworth, M. F., Stainforth, J. N., Wright, R. & Graham, J. M.: Pasteurella multocida septicemia associated with chronic liver disease. Br. Med. J., 27: , Felty's syndrome: A case report. S. Afr. Med. J., 58: , ) Furie, R. A., Cohen, R. P. & Hartman, B. J.: Pasteurella multocida infection: Report inurban setting and review of spectrum of human 1) Atin, H. L. & Beethan, W. P.J.: Pasteurella disease. N. Y. State J. Med., 80: , multocida empyema: Report of case. N. Eng. J ) Lucas, G. L. & Burtlott, D. H.: Pasteurella multocida infection in the hand. Plastic & Reconstructive Surgery, 67: 49-53, ) Rose, H. D. & Mathai, G.: Acute Pasteurella multocida pneumonia. Br. J. Dis. Chest., 71: , ) Nelson, S. & Hammer, G. S.: Pasteurella multocida empyema: Case report and review of the literature. Am. J. Med. Sci., 281: 43-49, ) Johnson, R. H. & Rumans, L. W.: Unusual infections caused by Pasteurella mutocida. J. A. M. A., 237: , 1977.

6 Pasteurella Multocida Septicemia Associated with Pleuritis and Pericarditis Tetsuhide UNOKI*, Isao NAKAMURA*, Akira YOSHIOKA*, Kiyoshi NAKAYASU**, Hiroshi HONGOU**, Toshiaki KAMEI#, Masako KUNIHIRO## & Naoki UEDA Department of Internal Medicine*, of Surgery**, of Pathology#, and of Clinical Laboratory##, Yamaguchi Prefectural Central Hospital, Ohsaki 77, Hofu, Yamaguchi 747, Japan Pasteurella multocida (P. multocida) is well recognized as the causative agent of hemorrhagic septicemia and respiratory infection in animals. We report the first human case of survived P. multocida septicemia in Japan. A 19 year-old Japanese male, without any underlying disease, suffered with high fever and common cold symptome following intimate contacts with a dog as pet. He was admitted our hospital 10 days after onset. On physical examination, tachycardia, tachypnea, high fever, cardiomegaly, cardiac friction rub and moist rale in both lungs were revealed. Pericardial and pleural effusion were shown by chest X-ray, CT scan and echocardiogram. In spite of administration of ampicillin for 3 days, P. multocida was isolated from blood. The isolate was susceptible to majority of chemotherapeutics. But administration of cefazolin or cefmetazole combined with lincomycin was not effective. Surgical drainage of pleural and pericardial effusion was performed on the 10 hospital day. Pathologically, no malignancy was found in operative materials. After the operation there was not clinical improvement. By administration of thiamphenicol, marked clinical improvement was noted and the patient was discharged 5 weeks late. It is thought that both the surgical drainage and thiamphenicol administration might be effective in this case.