Antibiotic treatment following a dog bite in an immunocompromized patient in order to prevent Capnocytophaga canimorsus infection: a case report

Abstract

BackgroundCapnocytophaga canimorsus is a commensal bacterium found in the saliva of dogs and cats. Clinically significant infections in humans after a bite are often associated with the presence of immune deficiency. Early recognition and appropriate treatment are crucial for patient survival. In addition, patients with immune deficiency are susceptible to serious life-threatening nosocomial infections, which may also influence the prognosis of patients with Capnocytophaga canimorsus infection.Case presentationA 62-year-old Caucasian female was admitted with septic shock, acute respiratory distress syndrome, acute renal failure, metabolic acidosis and disseminated intravascular coagulation after suffering two small bites from her dog. She had received a splenectomy during childhood. The patient survived after early empiric treatment with antibiotics and intensive supportive care, including ventilation support, a high dose of noradrenalin, and continuous venovenous hemodialysis applied prior to the definitive diagnosis of Capnocytophaga canimorsus sepsis. She improved within 2 weeks but, despite all efforts to prevent nosocomial infection, her hospital course was complicated by Enterococcus species and Candida albicans pleuropneumonia that prolonged her stay in the intensive care unit, and necessitated ventilation support for 2 months.ConclusionSevere Capnocytophaga canimorsus sepsis may be complicated by life-threatening nosocomial infection in immunocompromized patients. The prophylactic application of antibiotics after a dog bite should be considered in high-risk individuals with immune deficiency in order to prevent both Capnocytophyga canimorsus sepsis and serious nosocomial complications.

A rare case of purulent meningitis caused by Capnocytophaga canimorsus in the Czech Republic – case report and review of the literature

“…This is the second reported case of an invasive infection caused by C. canimorsus in the Czech Republic (CZ). However, the first one manifested as a severe sepsis in a woman with splenectomy [15]. Thus the patient described in this report is the first case with purulent meningitis reported in CZ.…”

Capnocytophaga canimorsus: Rare cause of Fatal Septic Shock. Case report

“…All major studies and guidelines for the management of sepsis have highlighted the need for timely and appropriate administration of antibiotic therapy having a critical impact on patient survival [15][16][17]. Our patient was diagnosed and treated for severe sepsis with significant delay, which may have contributed to unfavorable outcome.…”

Microbiología de las infecciones causadas por mordeduras de perros y gatos en personas: Una revisión

“…En el presente trabajo, únicamente se tuvieron en cuenta los casos de mordeduras provocadas por perro o gato y cuyas víctimas posteriormente desarrollaron infección. La principal especie mordedora fue el perro con una afectación de 20 individuos (17 casos clínicos individuales, una serie presentó tres casos) 5,6,11,[22][23][24][25][26][27][28][29][30][31][32][33][34] . Por otra parte, 12 individuos fueron afectados por mordedura de gato que cursó con infección (de éstos, hubo seis publicados como casos clínicos y otros seis publicados en dos series de casos, presentando tres casos cada uno) 13,14,17,21,[35][36][37][38] .…”

“…Los factores predisponentes o comorbilidades más frecuentes en los pacientes que desarrollaron la infección fueron la esplenectomía previa 25,30,33,37 , hepatitis B o C o alcoholismo 11,34 y las alteraciones del sistema inmune 14,23,36,38 . En 18 casos los pacientes no presentaron factores predisponentes y, aun así, en cuatro de estos casos se produjo shock séptico 5,15,27,31 .…”