title: Mycotic Aneurysm following a Dog Bite: The Value of the Clinical History and Molecular Diagnostics.
abstract: A 63-year-old Caucasian taxi driver presented with a 3-week history of malaise, night sweats, 7 kg weight loss, generalized arthralgia, and persistent mid-lower abdominal pain. Blood inflammatory markers were raised, and a computed tomography scan demonstrated an irregular degeneration of the infrarenal aorta, with a differential diagnosis including aortic infection. An urgent type IV thoracoabdominal aneurysm repair was performed with a rifampicin-soaked aortic tube graft during an open procedure. No organisms were grown from multiple peripheral blood cultures or culture of the affected aorta. However, subsequent 16S ribosomal polymerase chain reaction analysis of the resected aorta identified Capnocytophaga canimorsus as the causative organism-a commensal that lives in the mouth of dogs and cats. The patient subsequently gave a history of multiple bites from his pet dog over recent months-the likely source of infection. He was treated with 8 weeks of intravenous antibiotics before switching to oral antibiotics for an additional 6 weeks.
authors.affiliation: Department of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK. Electronic address: john.evans@gstt.nhs.uk.
authors.forename: Terry J
authors.initials: TJ
authors.lastname: Evans
authors.affiliation: Department of Vascular Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Oliver T
authors.initials: OT
authors.lastname: Lyons
authors.affiliation: Department of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Aisling
authors.initials: A
authors.lastname: Brown
authors.affiliation: Department of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Price
authors.affiliation: Department of Vascular Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Bell
authors.affiliation: Department of Vascular Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Morad
authors.initials: M
authors.lastname: Sallam
mesh_terms: D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D001027:Aortography / Q000379:methods; D001733:Bites and Stings / Q000150:complications / Q000382:microbiology*; D019917:Blood Vessel Prosthesis Implantation; D002206:Capnocytophaga / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D000072226:Computed Tomography Angiography; D004285:Dogs; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000382:microbiology* / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography; D021521:Ribotyping; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents