Case Report: Acute Myocardial Infarction Associated with DF-2 Bacteremia After a Dog Bite

Newton, Norris L.; Sharma, B

doi:10.1097/00000441-198605000-00012

Cited by 10 publications

(8 citation statements)

References 9 publications

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“…Systemic infections (Table 1) were mainly septicemias (94 cases), associated to meningitis in 13 cases, to cardiac localization in 11 cases (9 endocarditis, 1 tricuspid valve infected myxoma and 1 myocardial infarction possibly attributable to C. canimorsus, because of the young age of the patient) [18]. Systemic infections (Table 1) were mainly septicemias (94 cases), associated to meningitis in 13 cases, to cardiac localization in 11 cases (9 endocarditis, 1 tricuspid valve infected myxoma and 1 myocardial infarction possibly attributable to C. canimorsus, because of the young age of the patient) [18].…”

Section: Review Of the Literaturementioning

confidence: 99%

Capnocytophaga canimorsus infections in human: Review of the literature and cases report

1996

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Capnocytophaga canimorsus, formerly designated Dysgonic fermenter 2 (DF-2) was first described in 1976; it is a commensal bacterium of dogs and cats saliva, which can be transmitted to man by bite (54% of cases), scratch (8.5%), or mere exposure to animals (27%). We present a review of the clinical and microbiological characteristics of the Capnocytophaga canimorsus infections and 12 cases of infection in France. Over 100 cases of human infections have been reported, mainly septicemia in patients with diminished defences, due to splenectomy (33%), alcohol abuse (24%), immunosuppression (5%). However 40% of septicemia occur in patients with no predisposing conditions. Other infections are less frequent: meningitis, endocarditis, arthritis, pleural and localized eye infections. These infections range from mild to fulminating disease, with shock, respiratory distress, disseminated intravascular coagulation. Dermatological lesions (macular or maculopapular rash, purpura) or gangrene are common. This fastidious Gram-negative bacterium grows slowly on chocolate agar or on heart infusion agar with 5% rabbit blood incubated in 5% CO2. In spite of a great susceptibility of bacteria to antibiotics, the mortality is of 30%. Because of the severity of these infections, taking into account this organism in the management of bites is necessary, especially in patients with predisposing factors.

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Section: Review Of the Literaturementioning

confidence: 99%

Capnocytophaga canimorsus infections in human: Review of the literature and cases report

1996

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A 42-year-old man, a smoker, came to the emergency room with a clinical picture of septic shock and acute myocardial infarction.

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confidence: 99%

“…In patients with septic shock, it has been known for many years that the myocardium is affected, with reduced systolic function that has been attributed to increased levels of TNF, nitric oxide and other agents. In spite of this, only a few cases in the literature report sepsis as the cause of acute myocardial infarction [1,2,3].…”

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confidence: 99%

Acute myocardial infarction with normal coronary arteries during septic shock from Neisseria meningitidis

Filippatos

Kardara

Paramithiotou

et al. 2000

Intensive Care Medicine

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Sir: Very few cases have been reported in the literature where acute myocardial infarction occurs during sepsis [1,2,3]. We describe a patient with normal coronary arteries who had an acute myocardial infarction during septic shock caused by Neisseria meningitidis.A 42-year-old man, a smoker, came to the emergency room with a clinical picture of septic shock and acute myocardial infarction. The history of the disease had begun 2 days before admission with fever, vomiting, abdominal pain and diarrhea. The patient treated the symptoms himself with antipyretic and anti-emetic medication. He was admitted to the ICU. Examination of the central nervous system and remaining systems gave no pathologic findings. His blood pressure was 85/50 mmHg on dobutamine. The ECG showed ST segment elevation in leads I, II, III, aVF and V 4±6 . On echocardiography the left ventricle had normal dimensions with reduced systolic function, the most severe hypokinesia being in the inferior wall, ejection fraction 30 % and mild mitral regurgitation. Initial laboratory tests gave WBC 28,400 (95 % polymorphonuclear), hematocrit 31 %, platelets 64,000, INR 1.93, glucose 214 mg/dl, urea 92 mg/dl, creatinine 2.02 mg/dl, CPK 2000 U/l, with CPK-MB 373 U/l and LDH 378 U/l. Right cardiac catheterization showed CVP 6 mmHg, wedge pressure 8 mmHg and low cardiac output.Blood and urine cultures were taken and the patient was treated with fluids, dobutamine and antibiotics (penicillin, ceftriaxone, amikacin and tetracycline). Ultrasound examination of the abdomen, CT scan of the brain and CSF were negative. On the next days the blood cultures which had been taken on admission were positive for meningococcus type B, which was sensitive to the antibiotics already being given. The ECG showed the progressive changes of myocardial infarction. Six days after his admission the patient's clinical condition had improved significantly. All biochemical and hematologic parameters had returned to normal and left ventricular systolic function had improved significantly, without inotropes. The i. v. antibiotics were continued for 2 weeks and the patient left the hospital in good general condition. After 2 weeks he returned for a coronary angiographic examination that showed normal coronary arteries with an ejection fraction of 55 %. One year after the episode the patient continues to be in excellent health.

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“…Since 2000, the Laboratory of Healthcare-associated Infections, Colindale, London, has received (on average) one isolate of C. canimorsus for identification per year, one of which was from a patient with endocarditis (M. E. Kaufmann, personal communication). Prolonged periods with negative blood cultures and previous hospital admission occurred in several of the previously reported cases of endocarditis in this review (Shankar et al, 1980;Worthington et al, 1984;Archer, 1985;Newton & Sharma, 1986). Blood cultures may be negative in the early stages of infection by this organism and subcultures can take up to 7 days incubation in CO 2 before visible growth is apparent.…”

Section: Resultsmentioning

confidence: 67%

“…Such slow growth explains how C. canimorsus may be a cause of apparently culture-negative endocarditis. C. canimorsus sepsis has also been associated with myocardial infarction (Newton & Sharma, 1986;Ehrbar et al, 1996) and post-mortem examination of two cases in a study from Denmark revealed myocarditis (Pers et al, 1996). Susceptibility testing is difficult and standardized methods are not available.…”

Section: Resultsmentioning

confidence: 99%

Capnocytophaga canimorsus endocarditis

Sandoe

2004

Journal of Medical Microbiology

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Capnocytophaga canimorsus is a fastidious, Gram-negative rod that forms part of the normal oral flora of dogs and cats. Known for its ability to cause fulminant sepsis following dog bites, particularly in asplenic patients or alcoholics, this bacterium is also an uncommon cause of endocarditis. This article reviews 12 cases of endocarditis caused by C. canimorsus. Mean age of patients was 53 years, with 78 % of cases occurring in males. Overall, a history of dog-bite was documented in four cases (33 %) and a further four (33 %) reported contact with dogs. Four (33 %) of the endocarditis cases had underlying cardiological risk factors and two abused alcohol, but none had had a previous splenectomy. Subacute presentation, often involving more than one hospital admission, was common, as were initially negative blood cultures. A variety of antibiotics was used, but penicillins were the most common therapy. Three (25 %) of the 12 endocarditis patients died.

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Case Report: Acute Myocardial Infarction Associated with DF-2 Bacteremia After a Dog Bite

Cited by 10 publications

References 9 publications

Capnocytophaga canimorsus infections in human: Review of the literature and cases report

Capnocytophaga canimorsus infections in human: Review of the literature and cases report

Acute myocardial infarction with normal coronary arteries during septic shock from Neisseria meningitidis

Capnocytophaga canimorsus endocarditis

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