title: Capnocytophaga canimorsus Meningitis: Three Cases and a Review of the Literature.
abstract: Bacterial meningitis is a disease with a high morbidity and mortality. It may be caused by the zoonotic pathogen Capnocytophaga canimorsus, which is part of the commensal oral flora in dogs and cats. We report three cases of C. canimorsus meningitis in a nationwide cohort study of bacterial meningitis patients and performed a review of the literature. Three episodes of C. canimorsus meningitis were identified in three patients included in a nationwide cohort study from 2006 through 2014. The calculated annual incidence was 0.03 per million adults. When combined with the literature, 33 patients were identified of which 28 were male (85%). The median age was 63 years, and 13 (42%) were immunocompromised, which consisted of alcoholism in 7 (21%). Animal contact could be established in 29 of 30 patients (93%) and consisted of dog bites in 22 of 29 (76%). One patient died (3%) and 8 had neurological sequelae upon discharge (25%), most often hearing loss (n = 6, 19%). Capnocytophaga canimorsus meningitis is associated with dog bites. Although mortality is relatively low, survivors often have neurological sequelae.
authors.affiliation: Department of Neurology, Academic Medical Centre, Centre of Infection and Immunity Amsterdam (CINIMA), Amsterdam, the Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: van Samkar
authors.affiliation: Department of Neurology, Academic Medical Centre, Centre of Infection and Immunity Amsterdam (CINIMA), Amsterdam, the Netherlands.
authors.forename: M C
authors.initials: MC
authors.lastname: Brouwer
authors.affiliation: Department of Global Health, Academic Medical Centre, Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands.|Department of Medical Microbiology, Academic Medical Centre, Centre of Infection and Immunity Amsterdam (CINIMA), Amsterdam, the Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Schultsz
authors.affiliation: Department of Medical Microbiology, Academic Medical Centre, Centre of Infection and Immunity Amsterdam (CINIMA), Amsterdam, the Netherlands.|Netherlands Reference Laboratory for Bacterial Meningitis, Academic Medical Centre, Amsterdam, the Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: van der Ende
authors.affiliation: Department of Neurology, Academic Medical Centre, Centre of Infection and Immunity Amsterdam (CINIMA), Amsterdam, the Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: van de Beek
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D004285:Dogs; D041965:Flavobacteriaceae; D045826:Flavobacteriaceae Infections / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000209:etiology / Q000382:microbiology*; D008875:Middle Aged; D015047:Zoonoses
keywords: Capnocytophaga canimorsus; dog bite; meningitis; zoonosis