[Fatal case of sepsis with Capnocytophaga canimorsus after a minor dog bite].
A healthy 54-year-old man presented at the emergency department with signs of sepsis. Four days prior he was bitten and scratched by his dog. Microscopy of the blood smear showed intracellular Gram-negative rods. Despite maximal treatment the patient died a day and a half after admission due to septic shock with multi-organ failure and disseminated intravascular coagulopathy. After extended incubation of the spleen culture a Gram-negative rod was isolated and identified as Capnocytophaga canimorsus based on 16s RNA analysis. This is a commensal microorganism found in the oropharynx of dogs and cats. Infection occurs 2-3 days after contamination. The clinical presentation is heterogeneous, and contamination can sometimes proceed to fulminant infection. The lethality of infection is 30%. A risk factor is often present, such assplenectomy, alcohol abuse or immunosuppression. Immediate antibiotic treatment may influence the course of infection. Antibiotic prophylaxis has also been proposed for high-risk patients with dog bites.
Kleijnen-Grebien
B
B
Laurentius Ziekenhuis, Roermond. bkleijnen@yahoo.com
Boorsma
S
S
Stals
F S
FS
van Schelven
R
R
D000818:Animals; D001733:Bites and Stings / Q000150:complications* / Q000382:microbiology*; D002206:Capnocytophaga / Q000302:isolation & purification*; D004285:Dogs; D017809:Fatal Outcome; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure; D012772:Shock, Septic / Q000209:etiology* / Q000382:microbiology; D014946:Wound Infection / Q000150:complications