SHM Converge Scientific Abstract ePoster Gallery-Et Tu, Capnocytophaga Canimorsus?

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This case describes a rapidly progressive, life-threatening infection caused by <strong>Capnocytophaga canimorsus</strong>, a fastidious, slow-growing gram-negative bacillus commonly found in the oral flora of <strong>dogs and some cats</strong>. Infection usually follows a <strong>dog bite or scratch</strong> and can lead to severe sepsis, meningitis, endocarditis, gangrene, and <strong>purpura fulminans</strong>.

The patient was a <strong>48-year-old man</strong> with major risk factors for severe infection, including <strong>splenectomy</strong>, <strong>alcohol use disorder</strong>, and complex medical history. He presented less than 24 hours after developing fever, chills, weakness, and night sweats, three days after a dog bite to the face. Although he initially appeared relatively stable, he rapidly deteriorated over the next 6–12 hours with fever, worsening tachycardia, hypoxia, shock, thrombocytopenia, rising creatinine, elevated liver enzymes, and high lactate. His skin became cold, mottled, and purplish in a reticular pattern with necrotic areas on the hands and legs, consistent with <strong>purpura fulminans</strong>.

Blood cultures became positive after 72 hours for <strong>Capnocytophaga canimorsus</strong>. He required emergent intubation, aggressive fluid resuscitation, vasopressors, broad-spectrum antibiotics, and IVIG. His course was complicated by refractory shock, disseminated intravascular coagulation, stress-induced cardiomyopathy, acute renal failure requiring long-term renal replacement therapy, and severe alcohol withdrawal, though he ultimately survived to discharge.

Key teaching points are the importance of recognizing <strong>risk factors for fulminant Capnocytophaga infection</strong>, maintaining a <strong>high index of suspicion</strong> after dog-bite exposure, and starting <strong>empiric antibiotics early</strong> because cultures may take up to 14 days to grow. Early identification can reduce morbidity and mortality.

Asset Subtitle

Catlyn N. Thigpen

Meta Tag

Author List Catlyn N. Thigpen, Folasade Arinze, Kevin Isaak, Luqman Croal-Abrahams

Category Clinical Vignettes

Concept Capnocytophaga canimorsus

Concept Sepsis

Concept Septic Shock

Concept Purpura Fulminans

Concept Dog Bite

Distinguished Non-Finalist

Presenter Organization Wellstar Kennestone

Presenting Author Catlyn N. Thigpen

Track Adult

Keywords

Capnocytophaga canimorsus

dog bite infection

purpura fulminans

sepsis

splenectomy

alcohol use disorder

gram-negative bacillus

blood cultures

empiric antibiotics

disseminated intravascular coagulation

Capnocytophaga canimorsus

Sepsis

Septic Shock

Purpura Fulminans

Dog Bite