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      • Record: found
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      Capnocytophaga canimorsus infection led to progressively fatal septic shock in an immunocompetent patient

      case-report

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          Abstract

          Background

          Capnocytophaga canimorsus infection is rare, with a high fatality rate; however, there are few cases of death with a rapid course. This study reports a progressively fatal case of C. canimorsus.

          Case Presentation

          A 68‐year‐old immunocompetent Japanese man was bitten and scratched on his right hand by a dog 6 days before emergency transportation to the emergency room with abdominal pain, back pain, and melena. The patient developed multiple‐organ failure. Despite antibiotic therapy, transfusion, vasopressor therapy, and continuous renal replacement therapy, the patient died from uncontrolled metabolic acidosis 4.5 h after admission. Approximately 80 h after admission, blood cultures were positive for C. canimorsus.

          Conclusions

          Capnocytophaga canimorsus infection can lead to rapid progression even in immunocompetent patients.

          Abstract

          Gram‐negative anaerobic, rod‐shaped bacteria were identified (Gram staining; 400×).

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          Most cited references18

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          Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America.

          Dennis L Stevens, Alan Bisno, Henry Chambers … (2014)
          A panel of national experts was convened by the Infectious Diseases Society of America (IDSA) to update the 2005 guidelines for the treatment of skin and soft tissue infections (SSTIs). The panel's recommendations were developed to be concordant with the recently published IDSA guidelines for the treatment of methicillin-resistant Staphylococcus aureus infections. The focus of this guideline is the diagnosis and appropriate treatment of diverse SSTIs ranging from minor superficial infections to life-threatening infections such as necrotizing fasciitis. In addition, because of an increasing number of immunocompromised hosts worldwide, the guideline addresses the wide array of SSTIs that occur in this population. These guidelines emphasize the importance of clinical skills in promptly diagnosing SSTIs, identifying the pathogen, and administering effective treatments in a timely fashion. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
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            Capnocytophaga canimorsus: an emerging cause of sepsis, meningitis, and post-splenectomy infection after dog bites.

            T. Butler (2015)
            Newly named in 1989, Capnocytophaga canimorsus is a bacterial pathogen found in the saliva of healthy dogs and cats, and is transmitted to humans principally by dog bites. This review compiled all laboratory-confirmed cases, animal sources, and virulence attributes to describe its epidemiology, clinical features, and pathogenesis. An estimated 484 patients with a median age of 55 years were reported, two-thirds of which were male. The case-fatality rate was about 26%. Its clinical presentations included severe sepsis and fatal septic shock, gangrene of the digits or extremities, high-grade bacteremia, meningitis, endocarditis, and eye infections. Predispositions were prior splenectomy in 59 patients and alcoholism in 58 patients. Dog bites before illness occurred in 60%; additionally, in 27%, there were scratches, licking, or other contact with dogs or cats. Patients with meningitis showed more advanced ages, higher male preponderance, lower mortality, and longer incubation periods after dog bites than patients with sepsis (p < 0.05). Patients with prior splenectomy presented more frequently with high-grade bacteremia than patients with intact spleens (p < 0.05). The organism possesses virulence attributes of catalase and sialidase production, gliding motility, cytotoxin production, and resistance to killing by serum complement due to its unique lipopolysaccharide. Penicillin is the drug of choice, but some practitioners prefer third-generation cephalosporins or beta-lactamase inhibitor combinations. C. canimorsus has emerged as a leading cause of sepsis, particularly post-splenectomy sepsis, and meningitis after dog bites.
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              Capnocytophaga canimorsus septicemia in Denmark, 1982-1995: review of 39 cases.

              Jacob Hansen, C Pers, W Frederiksen (1996)
              Thirty-nine Danish cases of Capnocytophaga canimorsus septicemia were reviewed to determine the clinical course of this infection. The cases of septicemia were related to recent dog bites or other close contact with dogs. The period from the bite to the onset of symptoms ranged from 1 to 8 days. The mean age of the patients was 59.1 years (range, 28-83 years). Underlying conditions included previous splenectomy and alcoholism. Thirteen patients had previously been in good health. Common initial symptoms were fever, malaise, myalgia, vomiting, diarrhea, abdominal pain, dyspnea, confusion, headache and skin manifestations. Disseminated intravascular coagulation developed in 14 patients, meningitis in 5, and endocarditis in 1. Twelve of the patients died. All patients except two were treated with penicillin or ampicillin. Five patients had received antibiotics prior to admission. Attention should be drawn to C. canimorsus septicemia in cases of febrile illness following dog bites or contact with dogs, as well as those involving previously healthy persons. The incidence of this condition in Denmark is estimated to be 0.5 case per 1 million people per year.
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                Author and article information

                Contributors
                Ryuichi Nakayama:
                ORCID: https://orcid.org/0000-0002-3272-7680
                ryuichin.smu99@gmail.com
                Journal
                Journal ID (nlm-ta): Acute Med Surg
                Journal ID (iso-abbrev): Acute Med Surg
                Journal ID (doi): 10.1002/(ISSN)2052-8817
                Journal ID (publisher-id): AMS2
                Title: Acute Medicine & Surgery
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2052-8817
                Publication date (Electronic): 19 February 2022
                Publication date Collection: Jan-Dec 2022
                Volume: 9
                Issue: 1 ( doiID: 10.1002/ams2.v9.1 )
                Electronic Location Identifier: e738
                Affiliations
                [ 1 ] Department of Emergency Medicine Hakodate Municipal Hospital Hakodate Japan
                [ 2 ] Department of Gastroenterology Hakodate Municipal Hospital Hakodate Japan
                [ 3 ] Department of Emergency Medicine Sapporo Medical University School of Medicine Sapporo Japan
                [ 4 ] Department of Hygiene Sapporo Medical University School of Medicine Sapporo Japan
                [ 5 ] Department of Veterinary Medicine National Institute of Infectious Diseases Tokyo Japan
                Author notes
                [*] [* ] Corresponding: Ryuichi Nakayama, MD, Department of Emergency Medicine, Sapporo Medical University, 291 Minami 1‐jo Nishi 16‐chome, Chuo‐ku, Sapporo, Hokkaido 060‐8556, Japan. E‐mail: ryuichin.smu99@ 123456gmail.com

                Author information
                https://orcid.org/0000-0002-3272-7680
                https://orcid.org/0000-0002-8066-9163
                Article
                Publisher ID: AMS2738 Other ID: AMS-2021-0184.R2
                DOI: 10.1002/ams2.738
                PMC ID: 8857961
                PubMed ID: 35223046
                SO-VID: f57e774f-442a-4a85-9c03-1fd258c030aa
                Copyright © © 2022 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                Date revision received : 20 January 2022
                Date received : 07 September 2021
                Date accepted : 03 February 2022
                Page count
                Figures: 2, Tables: 2, Pages: 6, Words: 2460
                Categories
                Subject: Case Report
                Subject: Case Report
                Custom metadata
                source-schema-version-number 2.0
                cover-date January/December 2022
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.1 mode:remove_FC converted:19.02.2022

                Keywords: capnocytophaga canimorsus,disseminated intravascular coagulation,dog bite,metabolic acidosis,septic shock
                Data availability:
                Keywords: capnocytophaga canimorsus, disseminated intravascular coagulation, dog bite, metabolic acidosis, septic shock

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