A small ‘lick’ will sink a great ship: fulminant septicaemia after dog saliva wound treatment in an asplenic patient

Capnocytophaga canimorsus (C. canimorsus) is an emerging pathogen in critical care. C. canimorsus is a Gram-negative bacillus, commonly isolated as a commensal microorganism of the oral flora of healthy dogs and cats. A 63-year-old woman came to the emergency department with fever, chills, and malaise 2 days after a minor dog bite. After admission to the medicine ward, she developed respiratory failure and livedo reticularis. In the intensive care unit (ICU), she presented full-blown septic shock with thrombocytopenia, coagulopathy, severe acute kidney injury, and liver injury. We describe the first case of septic shock with Multiple Organ Dysfunction Syndrome related to Capnocytophaga canimorsus infection in Sardinia and its treatment in a tertiary hospital ICU. We also review recent literature on the relevance of C. canimorsus in human disease and critical illness.

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“…In the period 1990–2022, 125 articles described 207 cases of C. canimorsus infection (Supplemental Table). 12 …”

Section: Review Of the Literaturementioning

confidence: 99%

The Great pretender: the first case of septic shock due to Capnocytophaga canimorsus in Sardinia. A Case report and review of the literature

Sardo

Pes

Corona

et al. 2022

Journal of Public Health Research

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“…To the best of our knowledge, there are no reports of C. canimorsus infection complicated by compartment syndrome, however, there were some patients who underwent limb amputation. 2…”

Section: Introductionmentioning

confidence: 99%

“…Capnocytophaga canimorsus infection is rare in Japan, with just 93 patients (19 of whom died) confirmed from 1993 to the end of 2017 by the Ministry of Health, Labor and Welfare. To the best of our knowledge, there are no reports of C. canimorsus infection complicated by compartment syndrome, however, there were some patients who underwent limb amputation …”

Section: Introductionmentioning

confidence: 99%

Compartment syndrome due to Capnocytophaga canimorsus infection: a case report

Igeta

Hsu

Suzuki

et al. 2020

Acute Medicine & Surgery

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Background: Purpura fulminans secondary to Capnocytophaga canimorsus (C. canimorsus) infection without a wound is rare and often misdiagnosed initially. We report a patient who died due to C. canimorsus bacteremia with purpura fulminans and acute compartment syndrome of all extremities. Care Presentation: A 38-year-old Japanese man with a history of alcoholism presented with a 2-day history of gastroenteritis. The chief complaints were abdominal pain and diarrhea, and he had abdominal tenderness. Laboratory findings showed multiple organ failure. On day 2, pain in the lower extremities associated with motor and sensory dysfunction developed. On day 3, purpura on the whole body spread to all extremities. All four extremities became rigid, and acute compartment syndrome developed. The patient died due to uncontrolled hyperkalemia and lactic acidosis. Conclusions: Capnocytophaga canimorsus transmission can occur through licking or even close contact with animals when a risk factor of C. canimorsus infection, such as alcoholism, is present.

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Hand infections

Henry¹

2018

Current Orthopaedic Practice

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The integument provides only a limited barrier to protect the multiple functional structures of the hand from infection by common bacteria and other rare organisms. If infection is limited to just skin cellulitis, then antibiotics and careful monitoring may be all that is needed. Once bacteria become trapped in a deeper soft-tissue space and form an abscess then debridement must be performed to evacuate the purulence and necrotic tissue. Specialized compartments in the hand such as the pulp space, nail folds, joint cavities, and tendon sheaths facilitate bacterial containment and abscess formation, rendering immune response less effective. Osteomyelitis can originate from direct penetration or spread from an adjacent soft-tissue infection. Orthopaedic devices foster the development of a biofilm that can harbor bacteria, making resolution more difficult. The surgeon should obtain tissue for laboratory analysis at the deep infection site and subsequently administer empiric antibiotics while awaiting culture results. Greater duration of antibiotics is needed for infections of synovial tissues and bone. Unique infections caused by rare organisms may affect the hand, requiring recognition based on specific clinical features and confirmation by specialized laboratory testing.

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A small ‘lick’ will sink a great ship: fulminant septicaemia after dog saliva wound treatment in an asplenic patient

Cited by 5 publications

References 21 publications

The Great pretender: the first case of septic shock due to Capnocytophaga canimorsus in Sardinia. A Case report and review of the literature

The Great pretender: the first case of septic shock due to Capnocytophaga canimorsus in Sardinia. A Case report and review of the literature

Compartment syndrome due to Capnocytophaga canimorsus infection: a case report

Hand infections

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