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A rare case of Waterhouse-Friderichsen syndrome caused by Capnocytophaga canimorsus in an immunocompetent patient

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Abstract

A 53-year-old Caucasian male with hypertension and active tobacco abuse presented to a community hospital with a 2-day history of vague abdominal pain, myalgia and increased lethargy after being bitten on his right hand by the family dog while camping just 3 days prior to symptom onset. He expired within 90 min upon arrival to our intensive care unit. Pre-mortem blood cultures grew a fastidious Gram-negative aerobic rod that was identified as Capnocytophaga canimorsus. Autopsy findings showed multi-organ disseminated intravascular coagulopathy with microthrombi along with bilateral adrenal hemorrhage and necrosis of the adrenal glands consistent with Waterhouse-Friderichsen syndrome. This case contributes to the medical literature as a rare presentation of Capnocytophaga canimorsus infection in an otherwise immunocompetent patient and stresses the importance of a thorough history taking and physical examination by clinicians along with prompt administration of appropriate antibiotics.

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References

  1. Macrea M, McNamee M, Martin TJ. Acute onset of fever, chills, and lethargy in a 36-year-old woman. Chest. 2008;133:1505–7.

    Article  PubMed  Google Scholar 

  2. Cleuziou C, Binard A, Devauchelle-Pensec V, et al. beware man’s best friend. Spine. 2010;35:1520–1.

    Article  Google Scholar 

  3. Stiegler D, Gilbert JD, Warner MS, et al. Fatal dog bite in the absence of significant trauma: capnocytophaga canimorsus infection and unexpected death. Am J Forensic Med Pathol. 2010;31:198–9.

    Article  PubMed  Google Scholar 

  4. Pers C, Gahrn-Hansen B, Frederiksen W. Capnocytophaga canimorsus septicemia in Denmark, 1982-1995: review of 39 cases. Clin Infect Dis. 1996;23:71–5.

    Article  CAS  PubMed  Google Scholar 

  5. Hammoud D, Nassar R, Griffey M. Capnocytophaga canimorsus septicemia caused by a dog bite in an asplenic patient. Kans J Med. 2011;4(1):14–7.

    Google Scholar 

  6. Chaudhuri AK, Hartley RB, Maddocks AC. Waterhouse-Friderichsen syndrome caused by a DF-2 bacterium in a splenectomised patient. J Clin Pathol. 1981;34:172–3.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. Mirza I, Wolk J, Toth L, et al. Waterhouse-Friderichsen syndrome secondary to Capnocytophaga canimorsus septicemia and demonstration of bacteremia by peripheral blood smear. Arch Pathol Lab Med. 2000;124:859–63.

    CAS  PubMed  Google Scholar 

  8. Verghese A, Hamati F, Berk S, et al. Susceptibility of dysgonic fermenter 2 to antimicrobial agents in vitro. Antimicrob Agents Chemother. 1988;32:78–80.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  9. Shin H, Mally M, Meyer S, et al. Resistance of Capnocytophaga canimorsus to killing by human complement and polymorphonuclear leukocytes. Infect Immun. 2009;77:2262–71.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Fischer LJ, Weyant RS, White EH, et al. Intracellular multiplication and toxic destruction of cultured macrophages by Capnocytophaga canimorsus. Infect Immun. 1995;63:3484–90.

    PubMed Central  CAS  PubMed  Google Scholar 

  11. Brenner DJ, Hollis DG, Fanning GR, et al. Capnocytophaga canimorsus sp. nov. (formerly CDC group DF-2), a cause of localized wound infection following dog bite. J Clin Microbiol. 1989;27:231–5.

    PubMed Central  CAS  PubMed  Google Scholar 

  12. Bonatti H, Rossboth DW, Nachbaur D, et al. A series of infections due to Capnocytophaga spp in immuno suppressed and immunocompetent patients. Clin Microbiol Infect. 2003;9:380–7.

    Article  CAS  PubMed  Google Scholar 

  13. Tuuminen T, Viiri H, Vuorinen S. The Capnocytophaga canimorsus isolate that caused sepsis in an immuno sufficient man was transmitted by the large pine weevil hylobiusabietis. J Clin Microbiol. 2014;52:2716–7.

    Article  PubMed Central  PubMed  Google Scholar 

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On behalf of all authors, the corresponding author states that there is no conflict of interest. Also this manuscript does not contain clinical studies or experiments.

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Correspondence to Joseph David Cooper.

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Cooper, J.D., Dorion, R.P. & Smith, J.L. A rare case of Waterhouse-Friderichsen syndrome caused by Capnocytophaga canimorsus in an immunocompetent patient. Infection 43, 599–602 (2015). https://doi.org/10.1007/s15010-015-0740-7

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  • DOI: https://doi.org/10.1007/s15010-015-0740-7

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