SPECTRUM AND SIGNIFICANCE OF BACTEREMIA DUE TO MORAXELLA-CATARRHALIS

Fifty-eight cases of bacteremia due to Moraxella catarrhalis, includin g seven that occurred in patients treated at our facilities, are analy zed. The host's medical history plays a major role in the presentation and outcome of M. catarrhalis bacteremia. Bacteremia is typically acc ompanied by pneumonia in adults with underlying respiratory disease. M any neutropenic patients do not manifest a focus of infection; in cont rast, the source identified in healthy, immunocompetent patients is us ually the upper airway or the ears. In the recent literature, it has b een reported that a rash is typically absent in adults with bacteremic pneumonia and in immunocompetent hosts and that only some neutropenic patients have a rash. The prognosis is grave for patients with endoca rditis and for patients with immunoglobulin deficiency or neutropenia not related to a hematologic malignancy. In addition, mortality is sub stantial among bacteremic patients with respiratory conditions or othe r chronic debilities, especially when respiratory copathogens are pres ent. The prognosis is good for febrile neutropenic patients with under lying leukemia or lymphoma when the neutropenia resolves. When healthy , immunocompetent individuals are affected with M. catarrhalis bactere mia, their presentations range from self-limited febrile illness to li fe-threatening disease.