title: Antibiotic treatment following a dog bite in an immunocompromized patient in order to prevent Capnocytophaga canimorsus infection: a case report.
abstract: BACKGROUND
  Capnocytophaga canimorsus is a commensal bacterium found in the saliva of dogs and cats. Clinically significant infections in humans after a bite are often associated with the presence of immune deficiency. Early recognition and appropriate treatment are crucial for patient survival. In addition, patients with immune deficiency are susceptible to serious life-threatening nosocomial infections, which may also influence the prognosis of patients with Capnocytophaga canimorsus infection.
  
  
  METHODS
  A 62-year-old Caucasian female was admitted with septic shock, acute respiratory distress syndrome, acute renal failure, metabolic acidosis and disseminated intravascular coagulation after suffering two small bites from her dog. She had received a splenectomy during childhood. The patient survived after early empiric treatment with antibiotics and intensive supportive care, including ventilation support, a high dose of noradrenalin, and continuous venovenous hemodialysis applied prior to the definitive diagnosis of Capnocytophaga canimorsus sepsis. She improved within 2 weeks but, despite all efforts to prevent nosocomial infection, her hospital course was complicated by Enterococcus species and Candida albicans pleuropneumonia that prolonged her stay in the intensive care unit, and necessitated ventilation support for 2 months.
  
  
  CONCLUSIONS
  Severe Capnocytophaga canimorsus sepsis may be complicated by life-threatening nosocomial infection in immunocompromized patients. The prophylactic application of antibiotics after a dog bite should be considered in high-risk individuals with immune deficiency in order to prevent both Capnocytophyga canimorsus sepsis and serious nosocomial complications.
authors.forename: Ondrej
authors.initials: O
authors.lastname: Hloch
authors.forename: Dana
authors.initials: D
authors.lastname: Mokra
authors.forename: Jan
authors.initials: J
authors.lastname: Masopust
authors.forename: Jan
authors.initials: J
authors.lastname: Hasa
authors.affiliation: Metabolic Intensive Care Unit, Medical Department, 2nd Faculty of Medicine of Charles University and Faculty Hospital, Prague Motol, V Úvalu 84, 150 06 Prague 5, Czech Republic. jiri.charvat@lfmotol.cuni.cz.
authors.forename: Jiri
authors.initials: J
authors.lastname: Charvat
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001733:Bites and Stings / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology; D002206:Capnocytophaga / Q000276:immunology; D004211:Disseminated Intravascular Coagulation / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology; D004285:Dogs; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008875:Middle Aged; D011001:Pleuropneumonia / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology / Q000473:pathology; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology; D012772:Shock, Septic / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents