Doggonit! A Classic Case of Severe Capnocytophaga canimorsus Sepsis
Capnocytophaga canimorsus is a commensal organism often found in the oropharyngeal tracts of dogs and cats, capable of causing significant morbidity and mortality in immunocompromised patients. Early identification of C. canimorsus is challenging due to the organism’s rare presentation, rapid clinic...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Arizona Thoracic Society
2024-03-01
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| Series: | Southwest Journal of Pulmonary and Critical Care |
| Subjects: | |
| Online Access: | https://www.swjpcc.com/critical-care/2024/3/15/doggonit-a-classic-case-of-severe-capnocytophaga-canimorsus.html |
| _version_ | 1797260798335123456 |
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| author | Brittany Denzer MD Minh Do MD Alexandra N. Fuher MD Logan Harper MD Kaleigh Lindholm, MD Kara Calhoun MD MPH Kara Mould MD MPH |
| author_facet | Brittany Denzer MD Minh Do MD Alexandra N. Fuher MD Logan Harper MD Kaleigh Lindholm, MD Kara Calhoun MD MPH Kara Mould MD MPH |
| author_sort | Brittany Denzer MD |
| collection | DOAJ |
| description | Capnocytophaga canimorsus is a commensal organism often found in the oropharyngeal tracts of dogs and cats, capable of causing significant morbidity and mortality in immunocompromised patients. Early identification of C. canimorsus is challenging due to the organism’s rare presentation, rapid clinical progression, and slow growth on microbiological media. We present a case of a 47-year-old man with exposure to snakes and dogs, and history of severe alcohol use disorder, who presented to the emergency department with acute generalized abdominal pain. His course was notable for progressive respiratory failure requiring intubation and multi-pressor septic shock with minimal response to initial broad-spectrum antibiotics, complicated by hypoglycemia and DIC with purpura fulminans. Multidisciplinary review of the peripheral smear, notable for long, thin, intra and extracellular gram-negative rods, rapidly characterized our pathogen as an atypical gram-negative rod. With additional review of medical history and zoonotic exposures, we were able to quickly identify and address our concern for C. canimorsus, broadening our antibiotics to account for resistance patterns particular to this organism. |
| first_indexed | 2024-04-24T23:31:03Z |
| format | Article |
| id | doaj.art-dc880cc8271d4614a047637be5b8d406 |
| institution | Directory Open Access Journal |
| issn | 2160-6773 |
| language | English |
| last_indexed | 2024-04-24T23:31:03Z |
| publishDate | 2024-03-01 |
| publisher | Arizona Thoracic Society |
| record_format | Article |
| series | Southwest Journal of Pulmonary and Critical Care |
| spelling | doaj.art-dc880cc8271d4614a047637be5b8d4062024-03-15T14:42:28ZengArizona Thoracic SocietySouthwest Journal of Pulmonary and Critical Care2160-67732024-03-01283363910.13175/swjpccs003-24Doggonit! A Classic Case of Severe Capnocytophaga canimorsus SepsisBrittany Denzer MD0Minh Do MD1Alexandra N. Fuher MD2Logan Harper MD3Kaleigh Lindholm, MD4Kara Calhoun MD MPH5Kara Mould MD MPH6Department of Internal Medicine, University of Colorado Anschutz Medical Campus (Aurora)Department of Internal Medicine, University of Colorado Anschutz Medical Campus (Aurora)Department of Internal Medicine, University of Colorado Anschutz Medical Campus (Aurora)Department of Family Medicine, University of Colorado Anschutz Medical Campus (Aurora)Department of Pathology, Denver Health (Denver)Department of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus (Aurora)Department of Medicine, Division of Pulmonary, Critical Care & Sleep Medicine, National Jewish Health (Denver)Capnocytophaga canimorsus is a commensal organism often found in the oropharyngeal tracts of dogs and cats, capable of causing significant morbidity and mortality in immunocompromised patients. Early identification of C. canimorsus is challenging due to the organism’s rare presentation, rapid clinical progression, and slow growth on microbiological media. We present a case of a 47-year-old man with exposure to snakes and dogs, and history of severe alcohol use disorder, who presented to the emergency department with acute generalized abdominal pain. His course was notable for progressive respiratory failure requiring intubation and multi-pressor septic shock with minimal response to initial broad-spectrum antibiotics, complicated by hypoglycemia and DIC with purpura fulminans. Multidisciplinary review of the peripheral smear, notable for long, thin, intra and extracellular gram-negative rods, rapidly characterized our pathogen as an atypical gram-negative rod. With additional review of medical history and zoonotic exposures, we were able to quickly identify and address our concern for C. canimorsus, broadening our antibiotics to account for resistance patterns particular to this organism. https://www.swjpcc.com/critical-care/2024/3/15/doggonit-a-classic-case-of-severe-capnocytophaga-canimorsus.htmlcapnocytophaga canimorsussepsisdogcatscratchgram negative rodpurpura fulminansalcoholismperipheral smeartreatment |
| spellingShingle | Brittany Denzer MD Minh Do MD Alexandra N. Fuher MD Logan Harper MD Kaleigh Lindholm, MD Kara Calhoun MD MPH Kara Mould MD MPH Doggonit! A Classic Case of Severe Capnocytophaga canimorsus Sepsis Southwest Journal of Pulmonary and Critical Care capnocytophaga canimorsus sepsis dog cat scratch gram negative rod purpura fulminans alcoholism peripheral smear treatment |
| title | Doggonit! A Classic Case of Severe Capnocytophaga canimorsus Sepsis |
| title_full | Doggonit! A Classic Case of Severe Capnocytophaga canimorsus Sepsis |
| title_fullStr | Doggonit! A Classic Case of Severe Capnocytophaga canimorsus Sepsis |
| title_full_unstemmed | Doggonit! A Classic Case of Severe Capnocytophaga canimorsus Sepsis |
| title_short | Doggonit! A Classic Case of Severe Capnocytophaga canimorsus Sepsis |
| title_sort | doggonit a classic case of severe capnocytophaga canimorsus sepsis |
| topic | capnocytophaga canimorsus sepsis dog cat scratch gram negative rod purpura fulminans alcoholism peripheral smear treatment |
| url | https://www.swjpcc.com/critical-care/2024/3/15/doggonit-a-classic-case-of-severe-capnocytophaga-canimorsus.html |
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