title: Capnocytophaga canimorsus bacteremia: clinical features and outcomes from a Helsinki ICU cohort.
abstract: BACKGROUND
  Capnocytophaga canimorsus is a gram-negative rod capable of causing severe sepsis or septic shock. We studied the characteristics of patients with C. canimorsus bacteremia treated in intensive care unit (ICU).
  
  
  METHODS
  Patients with C. canimorsus bacteremia in the Helsinki University Hospital district from 2005 to 2014 were retrospectively reviewed using laboratory database and electronical patient records.
  
  
  RESULTS
  We identified 65 patients with C.canimorsus bacteremia. Of these, 16 (25%) were treated in an ICU. The most commonly affected organ systems were coagulation (94%) and kidney (69%). Mortality of ICU treated patients was 19%. Three survivors underwent lower limb amputations for gangrene. Only 25% of the patients were immune-compromised, but alcohol abuse was common (69%). All patients had a contact with dogs, but only 37% had a history of a dog-bite.
  
  
  CONCLUSIONS
  Capnocytophaga canimorsus infection may present with severe sepsis or septic shock with organ dysfunction, most frequently coagulopathy and acute kidney injury. Previously recognized risk factors are not always present. A dog in a household may be a sufficient exposure for developing a severe form of the disease. The possibility of C. canimorsus infection should be considered in patients with any contact with dogs, even in immunocompetent patients.
authors.affiliation: Division of Intensive Care Medicine, Department of Perioperative, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. johanna.hastbacka@hus.fi.
authors.forename: J
authors.initials: J
authors.lastname: Hästbacka
authors.affiliation: Division of Intensive Care Medicine, Department of Perioperative, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Hynninen
authors.affiliation: Department of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: E
authors.initials: E
authors.lastname: Kolho
mesh_terms: D000818:Animals; D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology*; D002206:Capnocytophaga / Q000302:isolation & purification*; D015331:Cohort Studies; D004285:Dogs; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies