SHM Converge Scientific Abstract ePoster Gallery-A Friendly Dog, an Unfriendly Pathogen: Non-Traumatic Dog Exposure Leading to Capnocytophaga Canimorsus Sepsis in a Patient With Well-Controlled Hiv

A Friendly Dog, an Unfriendly Pathogen: Non-Traumatic Dog Exposure Leading to Capnocytophaga Canimorsus Sepsis in a Patient With Well-Controlled Hiv

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A 67-year-old man with well-controlled HIV presented with weakness and malaise after a fall while walking his dog. Initial CTA of the abdomen and pelvis showed a distended bladder with mild bilateral hydronephrosis, and he was admitted with presumed severe sepsis from a urinary source, along with acute kidney injury and rhabdomyolysis. Although his urinalysis and imaging suggested urinary obstruction, his urine culture remained negative. On hospital day 3, blood cultures grew gram-negative rods, and he continued to have fever and rising white blood cell count despite ceftriaxone, prompting escalation to cefepime. By day 7, the organism was identified as Capnocytophaga canimorsus, and antibiotics were narrowed to ampicillin-sulbactam, followed by oral amoxicillin-clavulanate at discharge on day 11 after gradual improvement.<br /><br />The case highlights that C. canimorsus, a dog and cat oral flora organism, can cause severe sepsis even without bites or scratches. It is associated with high mortality and can lead to coagulopathy, multiorgan failure, meningitis, AKI, and cellulitis. Classic risk factors include asplenia, alcoholism, immunosuppression, male sex, and older age, though infection may occur after close dog exposure alone. In this patient, diagnostic anchoring on a urinary source delayed consideration of the true etiology until persistent fever and negative urine cultures prompted reassessment.<br /><br />The authors emphasize the need for early broad-spectrum antibiotics, careful clinical reassessment, and awareness that Capnocytophaga infection can occur in patients with limited traditional risk factors. They also note that rhabdomyolysis had not previously been reported with this infection. Prompt recognition and treatment likely prevented further deterioration and ICU admission.

Asset Subtitle

Sara Khandani

Meta Tag

Author List Agostina Velo, Andrea Ramirez Cazares, Jeremy A. Quentzel, Sara Khandani

Category Clinical Vignettes

Concept Capnocytophaga canimorsus

Concept Sepsis

Concept Multiorgan Dysfunction

Concept Asplenia

Concept Diagnostic Anchoring

Distinguished Non-Finalist

Presenter Organization Mount Sinai Morningside West

Presenting Author Sara Khandani

Track Adult

Keywords

Capnocytophaga canimorsus

sepsis

dog exposure

gram-negative rods

urinary obstruction

acute kidney injury

rhabdomyolysis

blood cultures

immunosuppression

antibiotic therapy

Capnocytophaga canimorsus

Sepsis

Multiorgan Dysfunction

Asplenia

Diagnostic Anchoring