62-year-old man with history of coronary heart disease and splenectomy presented to the emergency department with a 1-day history of fever and 3-day history of chest pain.
A 62-year-old male patient was diagnosed with Capnocytophaga canimorsus infection after he presented with a history of fever and chest pain. He had chest pain since 3 days and fever since a day. The patient’s medical history was notable for coronary heart disease. In addition, he had undergone a splenectomy after a car accident.
Four days before he presented with the symptoms, a dog bit him on his left hand and he sustained three bite wounds. Laboratory studies showed that the patient’s white cell count of 6,700 per cubic millimetre (reference range, 3900 to 10,200), a platelet count of 31,000 per cubic millimetre (reference range, 150,000 to 370,000), and a procalcitonin level of more than 100 μg per litre (reference value, ≤0.05).
The patient’s blood cultures were obtained and he was started on treatment with broad-spectrum antibiotic agents, including intravenous fluids and norepinephrine. Furthermore, the peripheral blood stream was reviewed, which showed a presence of both intracellular and extracellular bacilliform bacteria. After 17 hours, Capnocytophaga canimorsus was cultured.
C. canimorsus are are gram-negative, rod shaped, facultatively anaerobic bacteria found in the mouths of healthy cats and dogs as a part of the oral flora. It can be transmitted to humans via animal bites. The bacterium can particularly cause severe infection in patients with a history of splenectomy.
The patient died two days after he was admitted, despite treatment.
References
Capnocytophaga canimorsus Infection https://www.nejm.org/doi/full/10.1056/NEJMicm1916407
