Pasteurella multocida
Introduction
Introduction to killing Pasteurellosis Pasteurella multocida is widely found in the respiratory and intestinal tract of many livestock and wildlife. Most of human infections are caused by bites by cats, dogs or other animals, and the prevalence of infection is still unclear. The pathogenesis is still not clear. Skin lesions are common in the hands, forearms and lower limbs. The earliest wounds appear red and swollen, rapidly spreading and rupturing and expelling yellow bloody pus from multiple sinuses. Local pain is accompanied by severe pain. When the bite is deep, it can also cause periostitis and osteomyelitis. Diagnosis was based on medical history and isolation of slow-growing Gram-negative bacilli from pus or sputum. Penicillin and tetracycline have a good effect on this disease. basic knowledge Sickness ratio: 0.05% Susceptible people: no special people Mode of infection: intestinal infection Complications: periostitis osteomyelitis
Cause
More causes of Pasteurellosis
Causes:
The pathogen of pasteurella multocida is Pasteurella multocida, a Gram-negative bacillus, oval in shape, densely stained at both ends, with a capsule, available with blood or ferrous blood. Culture medium.
Pathogenesis:
The prevalence of infection with Pasteurella is not very clear, and the pathogenesis is still inaccurate. It may be the first invasion from the wound, rapid reproduction, causing a strong inflammatory reaction, resulting in redness and swelling of the wound, rapid spread and ulceration, severe pain. When the host's resistance is reduced, hemorrhagic sepsis can be caused.
Prevention
Multi-killing pasteurosis prevention
Skin lesions are common in the hands, forearms and lower limbs. The earliest wounds appear red and swollen, rapidly spreading and rupturing and expelling yellow bloody pus from multiple sinuses. Local pain is accompanied by severe pain. When the bite is deep, it can also cause periostitis and osteomyelitis. . When the host's resistance is reduced, it can cause hemorrhagic sepsis, and the bacteria can be detected in the sputum of patients with bronchiectasis. It was diagnosed mainly based on medical history and the isolation of slow-growing Gram-negative bacilli from pus or sputum.
Complication
More bactericidal complications of Pasteurellosis Complications periostitis osteomyelitis
Skin and wound infections can be complicated by septic shock, kidney, liver abscess, sepsis can be combined with heart failure, jaundice, liver failure, acute renal failure, respiratory distress and DIC. In more severe cases, hemolytic anemia, renal failure, insufficient bone marrow hematopoietic function compensation, and endocarditis, meningitis, bronchitis, pulmonary edema, toxic myocarditis, and toxic hepatitis may occur. When the bite is deep, it can also cause periostitis and osteomyelitis. Hemorrhagic sepsis can be caused when the host's resistance is reduced.
Symptom
More symptoms of Pasteurellosis common symptoms, slow growth, periostitis, severe pain, sepsis
Skin lesions are common in the hands, forearms and lower limbs. The earliest wounds appear red and swollen, rapidly spreading and rupturing and expelling yellow bloody pus from multiple sinuses. Local pain is accompanied by severe pain. When the bite is deep, it can also cause periostitis and osteomyelitis. When the host's resistance is reduced, it can cause hemorrhagic sepsis, and the bacteria can also be detected in the sputum of patients with bronchiectasis.
Examine
Multi-killing Pasteurellosis
A. Common blood test
Blood tests, especially white blood cell counts and classification tests, may indicate the extent of bacterial infection, but obtaining positive pathogens is critical for diagnosis and treatment. In order to improve the positive rate of pathogen culture, it should be noted that the specimen should be sent in time (preferably before the administration of antibiotics); multiple times; multiple parts should be taken (such as blood, urine, stool, bone marrow, sputum, secretion) The amount of specimens to be inspected should not be too small (for example, blood samples should be sent at least 1/10 of the medium, ie 5 to 10 ml).
Blood: The total number of white blood cells is significantly increased, reaching 10 ~ 30 × 109 / L, the percentage of neutrophils increased, more than 80%, there may be obvious nuclear left shift and intracellular poisoning particles. The number of white blood cells in a small number of Gram-negative sepsis and decreased immune function can be normal or slightly reduced.
In combination with clinical characteristics, multiple suspected bacteria should be cultured at the same time (general bacteria, anaerobic bacteria, L-type bacteria, fungi, etc.) at the same time for inspection. A drug susceptibility test should also be performed after isolation of the pathogen.
2. Bacterial culture:
1. Blood and bone marrow culture: blood culture is carried out by special instruments such as isotope culture instrument, gas phase spectrometer and Malthus culture instrument. The growth of Pasteurella is an important basis for the diagnosis of Pasteurella, but one blood. Culture does not necessarily lead to positive results, so it is necessary to continuously collect blood three times (10 to 15 minutes apart) in different parts of the body.
2. Pus or secretion culture: The pus or secretion culture of the primary infection is helpful in judging the pathogen of Pasteurellosis. Bacterial culture of pus or secretions from migratory lesions helps to identify P. pastoris and its pathogens.
(1) Immunofluorescence and ELISA antigen detection;
(2) Indium labeled immunoglobulin detection.
3. Blood bacterial culture and drug sensitivity test. This is the most valuable test for multi-killing Pasteurellosis.
Diagnosis
Diagnosis and identification of Pasteurella multocida
diagnosis
It was diagnosed mainly based on medical history and the isolation of slow-growing Gram-negative bacilli from pus or sputum.
Differential diagnosis
The disease should be differentiated from the following diseases
1. Typhoid fever: Because of the deficiency of righteousness in the disease, if the body is weak, or tired and tired, the living is abnormal, the cold temperature is uncomfortable, and the sexual intercourse is not good, it can lead to a deficiency of righteousness and anger. After 1 week, it continues to have high fever, and there may be rose rash, hearing loss, white blood cells, and eosinophils disappear. Fatda reaction is positive, blood culture has typhoid or paratyphoid bacillus growth. Serum typhoid antigen and typhoid bacillus DNA detection can be diagnosed early.
2. Miliary tuberculosis: The clinical manifestations of acute miliary lung TB are obvious symptoms such as acute onset, high fever, chills, headache, loss of appetite, lethargy, night sweats, etc., and blood culture is negative. Images of miliary tuberculosis were seen on chest X-rays 2 weeks after onset. PCR detection of Mycobacterium tuberculosis is helpful for diagnosis.
3. Allergic subsepsis: its clinical manifestations are similar to sepsis, fever can last for several months, but the symptoms of systemic poisoning are relatively light, and there may be remission; rash can occur repeatedly and repeatedly, repeated blood culture negative, Antibiotic treatment is ineffective and adrenal cortical hormone therapy is effective.
4. Hemorrhagic fever with renal syndrome: There are regional and seasonal, first, fever, and the symptoms are aggravated after heat retreat, and hypotension shock and oliguria appear successively. Early drunkenness, bleeding of skin and mucous membranes, proteinuria, and platelets decreased. Serum-specific IgM antibody testing can be used for early diagnosis.
