| Table 4-5 Select Gram-Negative Infections |
| | Disease | | Etiology/Vector | | Clinical Findings | | Treatment |
| | Glanders | | Burkholderia mallei
Contact with infected horses | | Ulcerated nodule at inoculation site with regional lymphadenopathy, ± “farcy buds” (nodules along lymph nodes) | | Sulfonamide |
| | Brucellosis
(Undulant fever)
(Malta fever) | | Brucella spp.
Direct contact with infected animal or ingestion of dairy (unpasteurized) infected meat | | Cyclic fevers, arthralgias, hepatosplenomegaly; rare skin involvement (violaceous papulonodular eruption)
↑ Risk: butchers, farmers, veterinarians | | Doxycycline combined
with rifampin |
| | Tularemia
(Rabbit fever)
(Deer fly fever) | | Francisella tularensis
Direct contact with wild animals like rabbits (rabbitborne), ticks (tick-borne) or deer flies | | Ulceroglandular: tender chancre-like papule or nodule with lymphadenopathy, lymph nodes may become fluctuan with suppuration
↑ Risk in hunters | | Streptomycin |
| | Vibrio infection | | Vibrio vulnificus
Ingestion of raw seafood or open wound exposed to seawater | | Fever, chills, abdominal pain, red to violaceous macules → painful hemorrhagic bullae with cellulitis
↑ Risk: diabetes, liver disease, immunosuppression | | Oral TCN |
| | Plague | | Yersinia pestis
Transmitted via flew bite from infected animals | | Myalgias, malaise, fever → small papule/ pustule at site of flea bite with swollen, painful flunctuant lymph nodes (“buboes”) | | Streptomycin (IM) |
| | Malakoplakia | | E. coli (± Pseudomonas aeruginosa , Proteus , Klebsiella ) | | Commonly affects urinary tract, rare skin involvement with weeping perianal plaque or polypoid mass
Histo: Michaelis–Gutmann bodies | | Cipro (long-term) or
surgical removal |
| | Rhinoscleroma | | Klebsiella rhinoscleromatis
Transmission via inhalation of droplets or contaminated material | | Infectious granulomas in nasal mucosa and respiratory tract, epistaxis, Hebra nose (destruction of nasal cartilage)
Histo: Mikulicz cell, Russell bodies | | Cipro |
| | Rat-Bite Fever
(Haverhill fever) | | Streptobacillus moniliformis
Direct contact from rodents or contaminated food | | Fever, arthritis, ± ulceration at site of bite and generalized morbilliform eruption with acral distribution | | Pencillin |
| | Cat Bite | | Pasteurella multocida | | Erythema, pain, tenderness with gray serous drainage from puncture wound | | Augmentin, irrigate site,
± tetanus prophylaxis |
| | Dog Bite | | Capnocytophaga canimorsus Pasteurella canis Pasturella multocida | | |
| | Human Bite | | Eikenella corrodens | | |
| | | | | | | | |
