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

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BMC Research Notes

, 7:432

First Online: 05 July 2014Received: 29 August 2013Accepted: 01 July 2014DOI: 10.1186-1756-0500-7-432

Cite this article as: Hloch, O., Mokra, D., Masopust, J. et al. BMC Res Notes 2014 7: 432. doi:10.1186-1756-0500-7-432


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.

KeywordsCapnocytophaga canimorsus Sepsis Multiorgan failure Nosocomial infection AbbreviationsAPACHEAcute physiology and chronic health evaluation

APTTActivated partial tromboplastin time

ARDSAcute respiratory distress syndrome

CRPC-Reactive protein

CVVHDContinuous venovenous hemodialysis

INRInternational normalized ratio

PICCPeripherally inserted central venous catheter

NT-proBNPN-Terminal pro-brain natriuretic peptide

RIFLERisk, injury, failure, loss of kidney function

SOFASequential organ failure assesment.

Electronic supplementary materialThe online version of this article doi:10.1186-1756-0500-7-432 contains supplementary material, which is available to authorized users.

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Autor: Ondrej Hloch - Dana Mokra - Jan Masopust - Jan Hasa - Jiri Charvat


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