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Erythromycin failure with subsequent Pasteurella multocida meningitis and septic arthritis in a cat-bite victim

J M Levin1, D A Talan

  • 1Department of Internal Medicine, Olive View/UCLA Medical Center, Sylmar 91342.

Annals of Emergency Medicine
|December 1, 1990
PubMed

Insights

Erythromycin is not effective for treating cat-bite wound infections caused by Pasteurella multocida. This antibiotic has poor in vitro activity and has led to treatment failures, including meningitis and septic arthritis.

Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Pharmacology

Background:

  • Animal bites, particularly from cats, can lead to serious bacterial infections.
  • Pasteurella multocida is a common pathogen in cat-bite associated infections.
  • Empiric antibiotic therapy is crucial for managing animal-bite wounds.

Observation:

  • A 75-year-old woman developed Pasteurella multocida meningitis and septic arthritis.
  • The patient was receiving erythromycin for a cat-bite wound infection.
  • Erythromycin demonstrated poor in vitro activity against the isolated Pasteurella multocida.

Findings:

  • Erythromycin treatment failure in a case of Pasteurella multocida meningitis and septic arthritis.
  • Literature review confirms poor in vitro activity of erythromycin against Pasteurella multocida.
  • Erythromycin has been linked to clinical failures in treating animal-bite infections.

Implications:

  • Erythromycin should not be used for empiric therapy of established animal-bite infections.
  • Optimal empiric antibiotic choices for animal-bite wounds require careful consideration.
  • Differential diagnosis of severe cat-bite associated sepsis should include meningitis and septic arthritis.

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