<i>Capnocytophaga canimorsus</i> Meningitis: Three Cases and a Review of the Literature

Samkar, Anusha van; Brouwer, Matthijs C.; Schultsz, Constance; Ende, Arie van der; Beek, Diederik van de

doi:10.1111/zph.12248

Cited by 26 publications

(21 citation statements)

References 33 publications

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“…In community‐acquired bacterial meningitis, typical CSF abnormalities predictive for bacterial meningitis have been defined as a CSF glucose level of less than 1.9 mmol/L, a ratio of CSF glucose to blood glucose of less than 0.23, a CSF protein level of more than 2.20 g/L, or a CSF leukocyte count of more than 2,000/mm3 . However, in zoonotic bacterial meningitis, these typical CSF abnormalities were often reported to be absent, especially in C. canimorsus meningitis . If cultures remain negative in suspected zoonotic bacterial meningitis, 16S ribosomal RNA PCR might be useful to identify the causative agent …”

Section: Discussionmentioning

confidence: 99%

“…However, in zoonotic bacterial meningitis, these typical CSF abnormalities were often reported to be absent, especially in C. canimorsus meningitis . If cultures remain negative in suspected zoonotic bacterial meningitis, 16S ribosomal RNA PCR might be useful to identify the causative agent …”

Section: Discussionmentioning

confidence: 99%

“…In reported cases, only one author prescribed simultaneous steroid without adverse event . In common meningitis, the dosage of corticosteroids differs between trials, but it has been recommended to prescribe 0.6 mg/kg of dexamethasone given 4 times a day for 4 days . Moreover, there is a lack of consensus regarding the benefit of prolonged steroid treatment with increased dosage in case of installed SNHL after bacterial meningitis.…”

Section: Discussionmentioning

confidence: 99%

“…13 However, in zoonotic bacterial meningitis, these typical CSF abnormalities were often reported to be absent, especially in C. canimorsus meningitis. 14…”

Section: Diagnostic Aspectsmentioning

confidence: 99%

“…9 In common meningitis, the dosage of corticosteroids differs between trials, but it has been recommended to prescribe 0.6 mg/kg of dexamethasone given 4 times a day for 4 days. 14,16 Moreover, there is a lack of consensus regarding the benefit of prolonged steroid treatment with increased dosage in case of installed SNHL after bacterial meningitis. Most authors consider that it should be treated as a labyrinthitis because common germs causing meningitis can be associated with labyrinthine fibrosis and even ossification.…”

Section: Therapeutic Aspectsmentioning

confidence: 99%

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“My Dog Deafened Me!”: Case Report of Capnocytophaga canimorsus Infection and Literature Review

et al. 2018

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Capnocytophaga canimorsus infection is an emerging zoonotic disease that could cause meningitis and subsequent sensorineural hearing loss (SNHL), especially in the immunocompromised population. It is a gram-negative rod that belongs to the normal oral flora of dogs and cats and may be transmitted to humans by biting or licking. Our case report and literature review showed that this postmeningitic SNHL has distinct features from common bacterial meningitis-related SNHL. We therefore discuss the diagnostic, therapeutic, and preventive aspects of this uncommon cause of SNHL. Because it is now the second-most common dog-bite transmitted pathogen, otolaryngologists are more likely to encounter this zoonotic disease and should be aware of its characteristics. Laryngoscope, 2018.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…13 However, in zoonotic bacterial meningitis, these typical CSF abnormalities were often reported to be absent, especially in C. canimorsus meningitis. 14…”

Section: Diagnostic Aspectsmentioning

confidence: 99%

Section: Therapeutic Aspectsmentioning

confidence: 99%

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“My Dog Deafened Me!”: Case Report of Capnocytophaga canimorsus Infection and Literature Review

et al. 2018

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Septic shock caused by Capnocytophaga canimorsus in a patient with heterozygous Pelger-Huët anomaly

et al. 2022

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Capnocytophaga canimorsus Meningitis: Diagnosis Using Polymerase Chain Reaction Testing and Systematic Review of the Literature

Hansen

Crum-Cianflone

2019

Infect Dis Ther

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Introduction Capnocytophaga canimorsus infections are associated with dog bites, especially in asplenic or immunocompromised patients, and typically manifest as sepsis and/or bacteremia. Meningitis has been rarely described, and its diagnosis may be delayed due to poor or slow growth using traditional culture techniques. We provide our experience using polymerase chain reaction (PCR) to establish the diagnosis and perform a comprehensive review of C. canimorsus meningitis cases to provide summary data on the clinical manifestations, diagnosis, and outcomes of this unusual infection. Methods A systematic review of the peer-reviewed English literature (PubMed, Embase, Ovid Medline) from January 1966 to March 2018 was conducted to identify cases of C. canimorsus meningitis. Data collected included demographics, risk factors, cerebrospinal fluid (CSF) findings, PCR results, treatments, and outcomes. Descriptive statistics are presented as numbers (percentages) and medians (ranges). Results A total of 37 patients were reviewed with a median age of 63 years (12 days to 83 years) with a male predominance (76%). A relatively low proportion had an immunocompromised state (16% splenectomy and 5% steroid use); the most common risk factor was alcoholism (19%). Fifty-nine percent reported a dog bite (all within ≤ 14 days prior to presentation), while 22% reported a non-bite dog exposure, 3% reported cat bite, and 3% reported both dog and cat exposures; 11% reported no animal contact. CSF parameters included a median white count of 1024 cells/mm 3 , 81% had neutrophilic predominance, median protein of 190 mg/dl, and median glucose CSF/serum ratio 0.23. In 54% of cases, blood cultures were positive for C. canimorsus (median, 4 days) and 70% had positive CSF cultures (median, 5 days). PCR established the diagnosis in eight (22%) cases. Antibiotic therapy was given for a median of 15 days (range, 7 to 42 days). Prognosis was overall favorable with only one (3%) death reported and adverse neurologic and/or physical sequelae in 19% of the survivors. Conclusion C. canimorsus meningitis is a rare but increasingly important clinical entity occurring in patients of all ages, typically after dog exposure. While classically considered an infection among immunocompromised patients, most cases have occurred in previously healthy, immunocompetent persons. Diagnosis may be rapidly established by PCR, and this test should be considered in culture-negative cases with associated exposures. Outcome was generally favorable after a median antibiotic duration of 15 days.

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Capnocytophaga canimorsus Meningitis: Three Cases and a Review of the Literature

Cited by 26 publications

References 33 publications

“My Dog Deafened Me!”: Case Report of Capnocytophaga canimorsus Infection and Literature Review

“My Dog Deafened Me!”: Case Report of Capnocytophaga canimorsus Infection and Literature Review

Septic shock caused by Capnocytophaga canimorsus in a patient with heterozygous Pelger-Huët anomaly

Capnocytophaga canimorsus Meningitis: Diagnosis Using Polymerase Chain Reaction Testing and Systematic Review of the Literature

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