, Volume 23, Issue 6, pp 570-571
Date: 14 Jul 2004

Cellulitis caused by Capnocytophaga cynodegmi associated with etanercept treatment in a patient with rheumatoid arthritis

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Capnocytophaga are facultative anaerobic gram-negative bacteria, part of the normal flora of the oral cavity of humans and domestic animals such as dogs and cats. There are two main pathogenic species isolated from animal sources, C. canimorsus and C. cynodegmi [2]. Three species of Capnocytophaga have been isolated from human sources: C. ochronacea, C. gingivalis and C. sputigena [1].

Bacteria are inoculated by direct dog or cat bite and cause local, or very rarely, disseminated infections. Splenectomy, chronic alcoholism and diabetes mellitus have all been reported to be significant risk factors [1, 2, 3]. In recent years, use of tumor necrosis factor (TNF)-α blocking agents to treat rheumatoid arthritis (RA) has increased, but concerns have arisen about opportunistic infections with these therapies [4]. We report the case of a patient treated with etanercept for RA who developed local cellulitis a few days after a bite from her own cat.

Case report

A 63-year-old RA patient treated succ