Overwhelming Capnocytophaga canimorsus infection in a patient with asplenia

BMJ Case Rep. 2014 Apr 23:2014:bcr2013202768. doi: 10.1136/bcr-2013-202768.

Abstract

Patients with asplenia are prone to overwhelming infections due to encapsulated organisms. We report a 62-year-old man presenting with fever and weakness. His medical history was significant for splenectomy and owning a dog as pet. The patient on examination had evidence of animal bite and scratch marks on his lower extremity and developed dry gangrene of multiple digits of his upper extremity soon after admission. The patient's initial blood cultures were positive for Gram-negative rods, but no organism was identified. Capnocytophaga canimorsus was the suspected organism and the patient's antibiotics were tailored accordingly, with good clinical recovery. The patient' blood cultures finally grew C canimorsus on day 20 for which the patient had already been treated with prior clinical judgement. Physicians should be aware of this organism in the setting of sepsis in patients with asplenia and use appropriate antibiotics until further results are obtained.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Capnocytophaga* / isolation & purification
  • Dogs
  • Gram-Negative Bacterial Infections / diagnosis*
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / transmission
  • Humans
  • Immunocompromised Host
  • Male
  • Middle Aged
  • Penicillanic Acid / analogs & derivatives
  • Penicillanic Acid / therapeutic use
  • Pets / microbiology
  • Piperacillin / therapeutic use
  • Piperacillin, Tazobactam Drug Combination
  • Postoperative Complications
  • Splenectomy*
  • Zoonoses / microbiology

Substances

  • Anti-Bacterial Agents
  • Piperacillin, Tazobactam Drug Combination
  • Penicillanic Acid
  • Piperacillin