Dysgonic fermenter 2 septicemia.
Dysgonic fermenter 2 (DF-2) is a slow-growing gram-negative bacillus causing a zoonotic infection that is acquired through dog bites or other contact with dogs. Splenectomized patients and those with alcoholic liver disease are most susceptible to DF-2 infection. The clinical picture can be one of fulminant septicemia and disseminated intravascular coagulation in the splenectomized patient; the presentation is milder in the alcoholic patient. The overall mortality from DF-2 septicemia among the 41 cases reported in the literature is 27%. The organism is sensitive to penicillin, resistant to aminoglycosides, and not easily grown on common media. It appears to be serum-sensitive in tests with normal human serum. Penicillin prophylaxis of dog bite wounds is especially important in high-risk patients. DF-2 infection should be considered when any splenectomized patient develops fulminant septicemia, disseminated intravascular coagulation, and peripheral gangrene. Examination of a gram stain of the peripheral blood or buffy coat is of value in such cases.
Hicklin
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Department of Medicine, Veterans Administration Medical Center, Johnson City, Tennessee 37684.
Verghese
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Alvarez
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D000368:Aged; D000818:Animals; D001733:Bites and Stings / Q000150:complications*; D004285:Dogs; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D013156:Splenectomy