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Marina S. Morgan

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date: 26 February 2021

Pasteurella multocida is an important human Gram-negative pathogen residing primarily in the oropharynx of mammals and transmitted through bites and scratches. Presentation is typically within 12 h of injury with rapidly spreading cellulitis or sepsis, leading to serious morbidity and mortality (up to 40%) if untreated. Diagnosis is clinical: fresh bite wound cultures are unhelpful, but the organism is usually cultured in cases with established infection, especially if presenting within 24 hours of the injury. Treatment requires thorough wound debridement, with delayed closure if possible, along with antimicrobials to provide empirical cover against pasteurellae and all the other expected pathogens (e.g. amoxicillin-clavulanate plus ciprofloxacin, or meropenem plus clindamycin). Prevention is by avoidance of animal bites or scratches and prompt hygienic management of wounds: antibiotic prophylaxis (amoxicillin-clavulanate or—for the penicillin allergic—doxycycline or azithromycin) should be reserved for high-risk bites (e.g. cat bites) or high-risk wounds that are difficult to debride.

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