Capnocytophaga canimorsus is a catalase-positive and oxidase-positive gram-negative bacillus commonly found in dog saliva that is a rare cause of infection in immunocompromised individuals. We report the case of a 70-year-old woman with Waldenström macroglobulinemia treated with ibrutinib and a history of bilateral shoulder arthroplasty and bilateral knee arthroplasty who reported a 1-year history of multi-joint pain and swelling. The patient resides with two pet dogs that often scratch and bite, penetrating the skin, and on culture was found to have Capnocytophaga canimorsus.

Colonic volvulus, where the colon twists around its mesentery, commonly occurs in the sigmoid and cecum. However, colonic volvulus of the splenic flexure is quite rare. Reported cases are limited but suggest that prolonged constipation in patients with either congenital anomalies, history of prior abdominal surgery, and or psychiatric history are described as common risk factors for large bowel volvulus. Here, we discuss a case of a 56-year-old man with a history of chronic constipation and no previous abdominal surgeries who presented to the emergency department with abdominal pain and distention. Further workup including a computed tomography imaging and decompressive via limited colonoscopy confirmed diagnosis of colonic volvulus of the splenic flexure. Surgical management of colonic volvulus is patient specific but invariably involves partial colectomy, as was performed in this case.

Periprosthetic joint infections (PJI) can be subcategorized into acute postoperative infections, occurring within three months of implantation, and delayed onset infections, occurring after three months of implantation. PJIs can be caused by numerous infectious etiologies. Here, we describe a unique case of a patient with a history of bilateral shoulder and knee replacements over five years. The patient received a diagnosis of Waldenströms macroglobulinemia five years before her admission but deferred ibrutinib treatment until one year before her admission. We believe that the timeline coincides with the development of multiple PJIs secondary to ibrutinib therapy. The patient presented with bilateral shoulder and knee pain and swelling, following a flu-like illness that had resolved one year before the admission. Her joint symptoms did not subside along with the remaining flu-like symptoms. Initially, her symptoms served as clues to the diagnosis; however, the diagnosis was finally made and supported by joint aspiration. The patient was treated with vancomycin 1.25 g in sodium chloride 0.9% 250 mL intravenous piggyback every 24 hours for the treatment of PJI and oral daptomycin 500 mg daily for six weeks as prophylaxis for PJI. In conclusion, physicians need to consider the development of PJIs when prescribing immunosuppressive therapy, as well as an early diagnosis to prevent further complications.