Abstract

Keywords: Capnocytophaga canimorsus; Dogs; Gangrene; Multi-organ failure.

Citation: Farah R, Ghantus T. Capnocytophaga canimorsus: Clinical image. J Clin Images Med Case Rep. 2024; 5(2): 2855.

Description

A 61-year-old man, with no known comorbidities, came to the emergency room on foot because of shortness of breath and chest pain while lying down, abdominal pain and fever with chills 38°C. In the background, apart from drinking alcohol from time to time, there is nothing to note, in his presence there are two dogs, there is no story of a bite but licking by the dogs in the face. In the emergency room, his condition worsened, abdominal pain increased, on suspicion of an abdominal catastrophe, a full-body CT was performed, including a CTA which did not demonstrate significant findings, blood tests revealed lactic acidosis, thrombocytopenia 9000, renal failure creatinine 3.6, and elevated C-reactive protein levels, liver function test abnormalities, leukocytosis 50.000, and high troponin level with normal ECG, echocardiography bed side showed a picture of suspected myocarditis, we ruled out DIC and TTP. Due to his severe condition and low blood pressure, the patient was ventilated, treated with vasopressor therapy and broad-spectrum antibiotic, septic shock was suspected and he was transferred to our critical care unit. On the second day he developed widespread purpura and, black rash on his face, and gangrene in the nose (Figure 1). Four days later a blood culture result was obtained that showed Capnocytophaga canimorsus. Two weeks later the patient died. C canimorsus should be strongly suspected in any case of septicemia following a dog bite. C canimorsus named in 1989, is a bacterial pathogen found in the saliva of healthy dogs and cats, and is transmitted to humans principally by dog bites. Prompt therapy may influence the potentially fatal course of systemic infection [1,2].

References

1. Deshmukh PM, Camp CJ, Rose FB, Narayanan S. Capnocytophaga canimorsus sepsis with purpura fulminans and symmetrical gangrene following a dog bite in a shelter employee. Am J Med Sci. 2004; 327(6): 369-72. doi: 10.1097/00000441-200406000- 00015. PMID: 15201655.
2. Lion C, Escande F, Burdin JC. Capnocytophaga canimorsus infections in human: review of the literature and cases report. Eur J Epidemiol. 1996;12(5): 521-33. doi: 10.1007/BF00144007. PMID: 8905316.