Capnocytophagia canimorsus – Severe sepsis in a previously well individual with no evidence of a cat or dog bite. A case report ^☆

Abstract

Capnocytophagia canimorsus (C. canimorsus) is a Gram-negative bacilli present in the gingival flora of canine and feline species. It is the second most common cause of infection following dog bites and contact with canine saliva, leading to severe sepsis in immunocompromised patients with no evidence of a breach to the skin. We present the case of a previously healthy 51-year-old male who presented with disseminated intravascular coagulopathy, acute renal failure with widespread haemorrhagic bullae and skin necrosis. He was treated empirically with broad-spectrum antibiotics for sepsis of unknown origin for several days before C. canimorsus infection was identified on blood cultures. Following this, a more detailed social history identified the vital historical detail that the patient owned 7 dogs. His purpura fulminans secondary to sepsis was managed conservatively with regular dressings by the Burns Department. Our experience demonstrates that C. canimorsus should be considered as a causative organism in patients presenting with sepsis of unknown origin after contact with domestic animals and treated with early antibiotic therapy.

Highlights

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  Consider canimorsus infection as a cause of sepsis in healthy patients with no evidence of dog/cat bites or scratches.

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  Infection may be severe, causing DIC and multi-organ failure.

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  The pathogen is slow-growing and difficult to isolate.

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  Empirical treatment with broad-spectrum antibiotics is required alongside regular dressings to minimize transdermal fluid losses and maintain core body temperature.