Capnocytophaga Induced Acute Necrotizing and Exudative Pericarditis with Abscess Formation

Abstract

We present the case of a 55-year-old gentleman, with bilateral pulmonary embolism and a large pericardial effusion that lead to a pericardial window with evacuation of creamy pus. Gram stains were negative, with culture growing Capnocytophaga. Pathology revealed acute necrotizing and exudative changes, including frank abscess formation. In developed countries, pericardial abscess and acute pericarditis are uncommon due to availability of broad-spectrum antibiotics. Pericardial abscess due to Capnocytophaga is even more uncommon.

Gemella morbillorum- and Capnocytophaga sp.-Related Mycotic Thoracic Aortic Aneurysm and Mediastinal Abscess: An Unusual Case Report, a Treatment Challenge, and a Review of Literature

“…On the other hand, Capnocytophaga genus was first isolated from a case of meningitis following a dog bite in 1976 [ 10 ], then was given its present name in 1989 due to its high CO2 requirement [ 11 ]. It also consists of nine species, out of which C. canimorsus is the main aggressive human pathogen, while most others are oral human commensals [ 12 , 13 ].…”

“…Capnocytophaga sp . has the ability to produce extracellular degrading enzymes to human tissues and evade phagocytosis [ 13 , 16 , 39 ], and is known for causing bite wound infections and severe sepsis [ 24 , 40 ]. It has also been implicated in cases of periodontitis [ 24 ], gingivitis [ 16 ], mucositis, ophthalmic lesions [ 16 ], cholecystitis [ 41 ], paravertebral abscesses [ 42 ], septic arthritis, peripartum infections [ 43 ], and endocarditis [ 44 ].…”

“…Unfortunately, there are no MIC cut-offs or guidelines on the choice and duration of antibiotics for Capnocytophaga infections [ 23 , 45 ], which definitely warrants careful susceptibility testing and interpretation on isolates [ 16 ]. Expert opinions recommend primarily using beta-lactamase inhibitor combinations, with alternatives that include imipenem-cilastatin, clindamycin, linezolid, and moxifloxacin [ 13 , 16 ]. The first challenge in appropriately managing our case was the need for a regimen that would cover all three bacteria ( Gemella , Capnocytophaga , and Streptococcus intermedius ) for an endovascular aortic infection.…”

Isolation and Characterization of Capnocytophaga bilenii sp. nov., a Novel Capnocytophaga Species Detected in a Gingivitis Subject

“…Capnocytophaga species are primarily commensals of the oral cavity in humans and animals, especially dogs and cats. They are recognized as opportunistic pathogens, leading to various extra-oral infections, including severe sepsis [ 2 ], bloodstream infections [ 3 ], abscess [ 4 , 5 ], vertebral osteomyelitis [ 6 ], pneumonia [ 7 ], and perinatal infections [ 8 ] in both immunocompetent and immunosuppressed patients. In addition, Capnocytophaga species have been thought to play a role in cancer development.…”