| Pasteurella CASE 1 • A 24 year old man has warmth, swelling, and tenderness progressing up his right arm over the past 12 hours. The previous day he visited the home of a friend. While trying to pick up his friend's pet cat, he was bitten on the right wrist. There was a deep puncture wound. Initially, he was concerned about the possibility of rabies, but he learned that the cat had recently received rabies vaccine. Within a day, pain and redness began at the bite site and began to spread up the arm. The patient had some flucloxacillin (an anti-staphyloccal penicillin) left over from a treatment he received for a skin infection, so he began taking it. It did not seen to slow the progression of his infection, so he came to the Emergency Center at KATH. • On physical examination, his temperature is 38.3 degrees. The only significant finding is on right upper extremity where there is hyperemia of the skin, warmth, swelling, and tenderness to the mid-humerus. There is also some tenderness in the right axilla. • The white blood cell count is 15,500 with 92% neutrophils. A blood culture is obtained before the patient is treated with ampicillin-sulbactam intravenously. In 36 hours, it grows Pasteurella multocida. The cellulitis and fever slowly resolved, and the patient was given a 14-day course of an oral antibiotic to complete treatment. He was instructed to return for an xray of his wrist at the end of treatment. Questions: 1. What was the source of this organism? |