Advertisement

Infection

, Volume 43, Issue 5, pp 599–602 | Cite as

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

  • Joseph David CooperEmail author
  • Robert Patrick Dorion
  • Joseph Lorenzo Smith
Case Report

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.

Keywords

Capnocytophaga canimorsus Waterhouse-Friderichsen syndrome Dog bite 

Notes

Conflict of interest

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.

References

  1. 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.CrossRefPubMedGoogle Scholar
  2. 2.
    Cleuziou C, Binard A, Devauchelle-Pensec V, et al. beware man’s best friend. Spine. 2010;35:1520–1.CrossRefGoogle Scholar
  3. 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.CrossRefPubMedGoogle Scholar
  4. 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.CrossRefPubMedGoogle Scholar
  5. 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. 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.PubMedCentralCrossRefPubMedGoogle Scholar
  7. 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.PubMedGoogle Scholar
  8. 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.PubMedCentralCrossRefPubMedGoogle Scholar
  9. 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.PubMedCentralCrossRefPubMedGoogle Scholar
  10. 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.PubMedCentralPubMedGoogle Scholar
  11. 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.PubMedCentralPubMedGoogle Scholar
  12. 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.CrossRefPubMedGoogle Scholar
  13. 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.PubMedCentralCrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Joseph David Cooper
    • 1
    Email author
  • Robert Patrick Dorion
    • 2
  • Joseph Lorenzo Smith
    • 3
  1. 1.Department of Internal MedicineGeisinger Medical CenterDanvilleUSA
  2. 2.Department of PathologyGeisinger Medical CenterDanvilleUSA
  3. 3.Department of Critical Care MedicineGeisinger Medical CenterDanvilleUSA

Personalised recommendations