Skip to main content

Capnocytophaga canimorsus: an emerging cause of sepsis, meningitis, and post-splenectomy infection after dog bites

European Journal of Clinical Microbiology & Infectious Diseases volume 34, pages 1271–1280 (2015)Cite this article

Abstract

Newly named in 1989, Capnocytophaga canimorsus is a bacterial pathogen found in the saliva of healthy dogs and cats, and is transmitted to humans principally by dog bites. This review compiled all laboratory-confirmed cases, animal sources, and virulence attributes to describe its epidemiology, clinical features, and pathogenesis. An estimated 484 patients with a median age of 55 years were reported, two-thirds of which were male. The case-fatality rate was about 26 %. Its clinical presentations included severe sepsis and fatal septic shock, gangrene of the digits or extremities, high-grade bacteremia, meningitis, endocarditis, and eye infections. Predispositions were prior splenectomy in 59 patients and alcoholism in 58 patients. Dog bites before illness occurred in 60 %; additionally, in 27 %, there were scratches, licking, or other contact with dogs or cats. Patients with meningitis showed more advanced ages, higher male preponderance, lower mortality, and longer incubation periods after dog bites than patients with sepsis (p < 0.05). Patients with prior splenectomy presented more frequently with high-grade bacteremia than patients with intact spleens (p < 0.05). The organism possesses virulence attributes of catalase and sialidase production, gliding motility, cytotoxin production, and resistance to killing by serum complement due to its unique lipopolysaccharide. Penicillin is the drug of choice, but some practitioners prefer third-generation cephalosporins or beta-lactamase inhibitor combinations. C. canimorsus has emerged as a leading cause of sepsis, particularly post-splenectomy sepsis, and meningitis after dog bites.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price includes VAT (USA)
Tax calculation will be finalised during checkout.

References

  1. Brenner DJ, Hollis DG, Fanning GR, Weaver RE (1989) Capnocytophaga canimorsus sp. nov. (formerly CDC Group DF-2), a cause of septicemia following dog bite, and C. cynodegmi sp. nov., a cause of localized wound infection following dog bite. J Clin Microbiol 27:231–235

    CAS  PubMed Central  PubMed  Google Scholar 

  2. Butler T, Weaver RE, Venkata Ramani TK, Uyeda CT, Bobo RA, Ryu JS, Kohler RB (1977) Unidentified gram-negative rod infection. A new disease of man. Ann Intern Med 86:1–5

    CAS  PubMed  Google Scholar 

  3. Krol-van Straaten MJ, Landheer JE, de Maat CEM (1990) Capnocytophaga canimorsus (formerly DF-2) infections: review of the literature. Neth J Med 36:304–309

    CAS  PubMed  Google Scholar 

  4. Lion C, Escande F, Burdin JC (1996) Capnocytophaga canimorsus infections in human: review of the literature and cases report. Eur J Epidemiol 12:521–533

    CAS  PubMed  Google Scholar 

  5. Tierney DM, Strauss LP, Sanchez JL (2006) Capnocytophaga canimorsus mycotic abdominal aortic aneurysm: why the mailman is afraid of dogs. J Clin Microbiol 44:649–651

    PubMed Central  PubMed  Google Scholar 

  6. Anveden P-A, Bjork J, Fritz H, Josefsson K (1986) Forsta svenska dodsfallet efter nya hundbakterien. Lakartidningen 83:1387–1388

    CAS  PubMed  Google Scholar 

  7. August JR (1988) Dysgonic fermenter-2 infections. J Am Vet Med Assoc 193:1506–1508

    CAS  PubMed  Google Scholar 

  8. Burdin JC, Lion C, Weber M, Schmitt J, de Korwin JD, Paille F (1989) Du danger occulte des morsures de chien: septicemies a DF-2. Ann Med Interne (Paris) 140:58–59

    CAS  Google Scholar 

  9. Cook N, Brown EM, Pope N (1989) DF-2 septicaemia following a dog bite in the absence of local inflammation. J Infect 18:89–90

    CAS  PubMed  Google Scholar 

  10. Denis C, Doco Lecompte T, Saltiel JC, Modaï J (1988) Septicémies à DF-2 (dysgonic fermenter type II): à propos d’une observation et revue de la littérature. Sem Hôpitaux Paris 64:3133–3135

    Google Scholar 

  11. Fournier JL, Soileux M, Kiredjian M, Cohen Y, Hoang The Dan P, Pourriat JL (1988) Septicemie a bacille a gram negatif de culture et d’identication difficiles après morsure de chien. Presse Med 17:1265

    CAS  PubMed  Google Scholar 

  12. Gómez Huelgas R, Porras J, Viciana P, San Román C, Martínez C, Miranda C (1988) Sepsis fulminante por DF2. Med Clin (Barc) 91:744–746

    Google Scholar 

  13. Herbst JS, Raffanti S, Pathy A, Zaiac MN (1989) Dysgonic fermenter type 2 septicemia with purpura fulminans. Dermatologic features of a zoonosis acquired from household pets. Arch Dermatol 125:1380–1382

    CAS  PubMed  Google Scholar 

  14. Holter J, Gundersen RO, Natås O, Haavik PE, Hoel T (1989) Dodelig infeksjon etter hundebitt. Tidsskr Nor Laegeforen 109:693–694

    CAS  PubMed  Google Scholar 

  15. Imanse JG, Ansink-Schipper MC, Vanneste JAL (1989) Dysgonic fermenter-2 meningitis simulating viral meningitis. Lancet 2:396–397

    CAS  PubMed  Google Scholar 

  16. Léonard F, Lima J, Gigi J, Wauters G (1987) Un cas de septicemie a bacille gram negatif du groupe DF-2, suite a une morsure de chien. Acta Clin Belg 42:173–176

    PubMed  Google Scholar 

  17. Niefield S, Young EJ (1988) Case report: native valve endocarditis caused by dysgonic fermenter type 2 bacilli. Am J Med Sci 296:69–70

    CAS  PubMed  Google Scholar 

  18. Perez RE (1988) Dysgonic fermenter-2 infections. West J Med 148:90–92

    CAS  PubMed Central  PubMed  Google Scholar 

  19. Vanderlaan J (1989) CDC group DF-2 septicemia. Clin Microbiol Newsl 11:23–24

    Google Scholar 

  20. Alberio L, Lämmle B (1998) Images in clinical medicine. Capnocytophaga canimorsus sepsis. N Engl J Med 339:1827

    CAS  PubMed  Google Scholar 

  21. Andersen HK, Pedersen M (1992) Infective endocarditis with involvement of the tricuspid valve due to Capnocytophaga canimorsus. Eur J Clin Microbiol Infect Dis 11:831–832

    CAS  PubMed  Google Scholar 

  22. Lopez G, Brown T, Hatch K, Nims L, Oty G, Umland E, Eidson M, Voorhees R, Sewell CM; Centers for Disease Control and Prevention (CDC) (1993) Capnocytophaga canimorsus sepsis misdiagnosed as plague—New Mexico, 1992. MMWR Morb Mortal Wkly Rep 42:72–73

    Google Scholar 

  23. Aslam A (1999) Life-threatening Capnocytophaga canimorsus infection after dog bite. J R Soc Med 92:140–141

    CAS  PubMed Central  PubMed  Google Scholar 

  24. Band RA, Gaieski DF, Goyal M, Perrone J (2011) A 52-year-old man with malaise and a petechial rash. J Emerg Med 41:39–42

    PubMed  Google Scholar 

  25. Banerjee TK, Grubb W, Otero C, McKee M, Brady RO, Barton NW (1993) Musculocutaneous mononeuropathy complicating Capnocytophaga canimorsus infection. Neurology 43:2411–2412

    CAS  PubMed  Google Scholar 

  26. Bang B, Zachariae C (2001) Capnocytophaga canimorsus sepsis causing Sweet’s syndrome. Acta Derm Venereol 81:73–74

    CAS  PubMed  Google Scholar 

  27. Bastida MT, Valverde M, Smithson A, Marco F (2014) Sepsis fulminante por Capnocytophaga canimorsus: diagnostic por espectrometria de masas con analizidor de tiempo de vuelo y desorcion/ionizacion laser. Med Clin (Barc) 142:230–231

    Google Scholar 

  28. Bateman JM, Rainford DJ, Masterton RG (1992) Capnocytophaga canimorus infection and acute renal failure. J Infect 25:112–114

    CAS  PubMed  Google Scholar 

  29. Biedermann P, Deligne D (2004) Meningite a Capnocytophaga canimorsus dans un tableau digestif initial trompeur. Ann Biol Clin (Paris) 62:110–114

    CAS  Google Scholar 

  30. Blanche P, Sicard D, Meyniard O, Ratovohery D, Brun T, Paul G (1994) Capnocytophaga canimorsus lymphocytic meningitis in an immunocompetent man who was bitten by a dog. Clin Infect Dis 18:654–655

    CAS  PubMed  Google Scholar 

  31. Brichacek M, Blake P, Kao R (2012) Capnocytophaga canimorsus infection presenting with complete splenic infarction and thrombotic thrombocytopenic purpura: a case report. BMC Res Notes 5:695

    PubMed Central  PubMed  Google Scholar 

  32. Bryson MS, Neilly I, Rodger S, Soutar RL (2003) Purpura fulminans associated with Capnocytophaga canimorsus infection. Br J Haematol 121:1

    PubMed  Google Scholar 

  33. Cabellos C, Verdaguer R, Olmo M, Fernández-Sabé N, Cisnal M, Ariza J, Gudiol F, Viladrich PF (2009) Community-acquired bacterial meningitis in elderly patients: experience over 30 years. Medicine (Baltimore) 88:115–119

    Google Scholar 

  34. Chambers GW, Westblom TU (1992) Pleural infection caused by Capnocytophaga canimorsus, formerly CDC group DF-2. Clin Infect Dis 15:325–326

    CAS  PubMed  Google Scholar 

  35. Chary S, Joshi M, Reddy S, Ryan C, Saddi V (2011) Septicemia due to Capnocytophaga canimorsus following dog bite in an elderly male. Indian J Pathol Microbiol 54:368–370

    PubMed  Google Scholar 

  36. Chodosh J (2001) Cat’s tooth keratitis: human corneal infection with Capnocytophaga canimorsus. Cornea 20:661–663

    CAS  PubMed  Google Scholar 

  37. Christiansen CB, Berg RMG, Plovsing RR, Møller K (2012) Two cases of infectious purpura fulminans and septic shock caused by Capnocytophaga canimorsus transmitted from dogs. Scand J Infect Dis 44:635–639

    PubMed  Google Scholar 

  38. Chu P, Howden BP, Jones S, Fell G, Roberts AK (2005) Once bitten, twice shy: an unusual case report of a mycotic aortic aneurysm. ANZ J Surg 75:1024–1026

    PubMed  Google Scholar 

  39. Clarke K, Devonshire D, Veitch A, Bellomo R, Parkin G (1992) Dog-bite induced Capnocytophaga canimorsus septicaemia. Aust N Z J Med 22:86–87

    CAS  PubMed  Google Scholar 

  40. Cleuziou C, Binard A, Devauchelle-Pensec V, Héry-Arnaud G, Jousse-Joulin S, Saraux A (2010) “Beware man’s best friend”. Spine (Phila Pa 1976) 35:E1520–E1521

    Google Scholar 

  41. Coutance G, Labombarda F, Pellissier A, Legallois D, Hamon M, Bachelet C, Lepage O (2009) Capnocytophaga canimorsus endocarditis with root abscess in a patient with a bicuspid aortic valve. Heart Int 4:e5

    PubMed Central  PubMed  Google Scholar 

  42. de Boer MGJ, Lambregts PCLA, van Dam AP, van ’t Wout JW (2007) Meningitis caused by Capnocytophaga canimorsus: when to expect the unexpected. Clin Neurol Neurosurg 109:393–398

    PubMed  Google Scholar 

  43. Decoster H, Snoeck J, Pattyn S (1992) Capnocytophaga canimorsus endocarditis. Eur Heart J 13:140–142

    CAS  PubMed  Google Scholar 

  44. Delanaye P, Dubois C, Mendes P, Bertholet M, Lambermont B (2002) Morsure de chien chez un patient splénectomisé. Rev Med Liege 57:40–44

    CAS  PubMed  Google Scholar 

  45. Delmas P, Sapori JM, Reverdy ME, Ducluzeaux R, Fleurette J (1992) Septicemie mortelle a Capnocytophaga canimorsus (exDF2). Med Mal Infect 22:465–466

    Google Scholar 

  46. Deprés-Brummer P, Buijs J, van Engelenburg KCA, Oosten HR (2001) Capnocytophaga canimorsus sepsis presenting as an acute abdomen in an asplenic patient. Neth J Med 59:213–217

    PubMed  Google Scholar 

  47. Deshmukh PM, Camp CJ, Rose FB, Narayanan S (2004) Capnocytophaga canimorsus sepsis with purpura fulminans and symmetrical gangrene following a dog bite in a shelter employee. Am J Med Sci 327:369–372

    PubMed  Google Scholar 

  48. de Smet MD, Chan CC, Nussenblatt RB, Palestine AG (1990) Capnocytophaga canimorsus as the cause of a chronic corneal infection. Am J Ophthalmol 109:240–242

    PubMed  Google Scholar 

  49. Drouet A, Smati S, Ferrer M-H, Martínez J-Y, Guilloton L, Felten D (2006) Meningite a Capnocytophaga canimorsus sans notion de morsure de chien. Presse Med 35:418–420

    PubMed  Google Scholar 

  50. Dudley MH, Czarnecki LA, Wells MA (2006) Fatal Capnocytophaga infection associated with splenectomy. J Forensic Sci 51:664–666

    PubMed  Google Scholar 

  51. Dutta JK (1998) Fulminant infection by uncommon organisms in animal bite wounds. Postgrad Med J 74:611–612

    CAS  PubMed Central  PubMed  Google Scholar 

  52. Eefting M, Paardenkooper T (2010) Capnocytophaga canimorsus sepsis. Blood 116:1396

    PubMed  Google Scholar 

  53. Ehrbar H-U, Gubler J, Harbarth S, Hirschel B (1996) Capnocytophaga canimorsus sepsis complicated by myocardial infarction in two patients with normal coronary arteries. Clin Infect Dis 23:335–336

    CAS  PubMed  Google Scholar 

  54. Ensor CR, Russell SD, Wittstein IS, Conte JV (2011) Capnocytophagia canimorsus sepsis in an asplenic heart transplant candidate with a left ventricular assist system. Prog Transplant 21:121–123

    PubMed  Google Scholar 

  55. Evans RJ (1991) DF2 septicaemia. J R Soc Med 84:749–750

    CAS  PubMed Central  PubMed  Google Scholar 

  56. Fent GJ, Kamaruddin H, Garg P, Iqbal A, Kelland NF, Hall IR (2014) Hypertensive emergency and type 2 myocardial infarction resulting from pheochromocytoma and concurrent Capnocytophaga canimorsus infection. Open Cardiovasc Med J 8:43–47

    PubMed Central  PubMed  Google Scholar 

  57. Finn M, Dale B, Isles C (1996) Beware of the dog! A syndrome resembling thrombotic thrombocytopenic purpura associated with Capnocytophaga canimorsus septicaemia. Nephrol Dial Transplant 11:1839–1840

    CAS  PubMed  Google Scholar 

  58. Freibergerová M, Parízková R, Zaloudíková B, Freiberger T, Juránková J, Burget I, Husa P (2007) Sepse vyvolana bakterli Capnocytophaga canimorsus moznosti diagnostiky a lecby. Klin Mikrobiol Infekc Lek 13:115–118

    PubMed  Google Scholar 

  59. Frigiola A, Badia T, Lovato R, Cogo A, Fugazzaro MP, Lovisetto R, Di Donato M (2003) Infective endocarditis due to Capnocytophaga canimorsus. Ital Heart J 4:725–727

    PubMed  Google Scholar 

  60. Froberg L, Kristensen S (2008) Capnocytophaga canimorsus sepsis efter hundebid. Ugeskr Laeger 170:1941

    PubMed  Google Scholar 

  61. Gallen IW, Ispahani P (1991) Fulminant Capnocytophaga canimorsus (DF-2) septicaemia. Lancet 337:308

    CAS  PubMed  Google Scholar 

  62. Gary A, Bravard P, Frebourg N, Collange O, Nouveau J, Carré D, Veber B, Moirot E, Joly P (2006) Purpura extensive au cours d’un choc septique a Capnocytophaga canimorsus: deux observations. Ann Dermatol Venereol 133:27–29

    CAS  PubMed  Google Scholar 

  63. Gasch O, Fernández N, Armisen A, Verdaguer R, Fernández P (2009) Community-acquired Capnocytophaga canimorsus meningitis in adults: report of one case with a subacute course and deafness, and literature review. Enferm Infecc Microbiol Clin 27:33–36

    PubMed  Google Scholar 

  64. Gibou D, Kassiotis P, Pouëdras P, Ambroselli C, Cochery T, Tattevin P (2008) Meningites a Capnocytophaga canimorsus. Med Mal Infect 38:32–33

    CAS  PubMed  Google Scholar 

  65. González-García A, Ferreiro JJ, López-Lopategui MC, Zabarte M (2004) Shock septico con purpura fulminans por Capnocytophaga canimorsus. Enferm Infecc Microbiol Clin 22:309–310

    PubMed  Google Scholar 

  66. Gottwein J, Zbinden R, Maibach RC, Herren T (2006) Etiologic diagnosis of Capnocytophaga canimorsus meningitis by broad-range PCR. Eur J Clin Microbiol Infect Dis 25:132–134

    CAS  PubMed  Google Scholar 

  67. Gouin P, Veber B, Collange O, Frebourg N, Dureuil B (2004) Un choc septique d’étiologie inhabituelle: Capnocytophaga canimorsus. Le chien est-il toujours le meilleur ami de l’homme? Ann Fr Anes Rean 23:1185–1188

    CAS  Google Scholar 

  68. Hajee S, Quadling K (2000) Capnocytophaga canimorsus infection—a fulminant case following a trivial dog-bite injury. S Afr Med J 90:878–879

    CAS  PubMed  Google Scholar 

  69. Handrick W, Schwede I, Steffens U (2010) Letal verlaufende Capnocytophaga-canimorsus-sepsis nach hundebiss. Med Klin (Munich) 105:739–741

    Google Scholar 

  70. Hantson P, Gautier PE, Vekemans M-C, Fievez P, Evrard P, Wauters G, Mahieu P (1991) Fatal Capnocytophaga canimorsus septicemia in a previously healthy woman. Ann Emerg Med 20:93–94

    CAS  PubMed  Google Scholar 

  71. Hartley JW, Martin ED, Gothard WP, Levine DF (1994) Fulminant Capnocytophaga canimorsus (DF2) septicaemia and diffuse intravascular coagulation in hairy cell leukaemia with splenectomy. J Infect 29:229–230

    CAS  PubMed  Google Scholar 

  72. Hawkins J, Wilson A, McWilliams E (2011) ‘Biting the hand that feeds’: fever and altered sensorium following a dog bite. BMJ Case Rep. doi:10.1136/bcr.08.2010.3265

    PubMed Central  PubMed  Google Scholar 

  73. Hayani O, Higginson LAJ, Toye B, Burwash IG (2009) Man’s best friend? Infective endocarditis due to Capnocytophaga canimorsus. Can J Cardiol 25:e130–e132

    PubMed Central  PubMed  Google Scholar 

  74. Hloch O, Mokra D, Masopust J, Hasa J, Charvat J (2014) Antibiotic treatment following a dog bite in an immunocompromized patient in order to prevent Capnocytophaga canimorsus infection: a case report. BMC Res Notes 7:432

    PubMed Central  PubMed  Google Scholar 

  75. Hovenga S, Tulleken JE, Möller LVM, Jackson SA, vd Werf TS, Zijlstra JG (1997) Dog-bite induced sepsis: a report of four cases. Intensive Care Med 23:1179–1180

    CAS  PubMed  Google Scholar 

  76. Howell JM, Woodward GR (1990) Precipitous hypotension in the emergency department caused by Capnocytophaga canimorsus sp nov sepsis. Am J Emerg Med 8:312–314

    CAS  PubMed  Google Scholar 

  77. Janda JM, Graves MH, Lindquist D, Probert WS (2006) Diagnosing Capnocytophaga canimorsus infections. Emerg Infect Dis 12:340–342

    PubMed Central  PubMed  Google Scholar 

  78. Kampinga GA, Bollen AE, Harmsen HJM, de Vries-Hospers HG (2002) Meningitis na triviale hondenbeet. Ned Tijdschr Geneeskd 146:73–76

    CAS  PubMed  Google Scholar 

  79. Kennel C, Barraud O, Lapebie F-X, Sparsa A, Duvoid T, Chapellas C, Hidri N, Francois B (2013) Facial purpura associated with Capnocytophaga canimorsus septicaemia; role of sunlight? Eur J Dermatol 23:427–428

    PubMed  Google Scholar 

  80. Kikuchi K, Ehara K, Miyasaka A, Koyama S, Yaguchi Y, Tamai K, Mitsui M, Notake S, Muramatsu K, Yanagisawa H, Kawakami Y (2005) A rare case of bacteremia due to Capnocytophaga canimorsus. J Jpn Soc Clin Microbiol 15:9–14

    Google Scholar 

  81. Kleijnen-Grebien B, Boorsma S, Stals FS, van Schelven R (2008) Fatale afloop van een sepsis met Capnocytophaga canimorsus na een triviale hondenbeet. Ned Tijdschr Geneeskd 152:1882–1885

    CAS  PubMed  Google Scholar 

  82. Kok RHJ, Wolfhagen MJHM, Mooi BM, Offerman JJG (1999) A patient with thrombotic thrombocytopenic purpura caused by Capnocytophaga canimorsus septicemia. Clin Microbiol Infect 5:297–298

    PubMed  Google Scholar 

  83. Kooter AJ, Derks A, Vasmel WLE (1999) Rapidly progressive tricuspid valve endocarditis caused by Capnocytophaga canimorsus infection in an immunocompetent host. Clin Microbiol Infect 5:173–175

    PubMed  Google Scholar 

  84. Kourelis T, Kannan S, Foley RJ (2010) An unusual case of septic shock in a geriatric patient. Conn Med 74:133–137

    PubMed  Google Scholar 

  85. Kristensen KS, Winthereik M, Rasmussen ML (1991) Capnocytophaga canimorsus infection after dog-bite. Lancet 337:849

    CAS  PubMed  Google Scholar 

  86. Krol-van Straaten MJ, Landheer JE, de Maat CEM (1990) Beware of the dog: meningitis in a splenectomised woman. Neth J Med 36:301–303

    CAS  PubMed  Google Scholar 

  87. Kullberg B-J, Westendorp RGJ, van ’t Wout JW, Meinders AE (1991) Purpura fulminans and symmetrical peripheral gangrene caused by Capnocytophaga canimorsus (formerly DF-2) septicemia—a complication of dog bite. Medicine 70:287–292

    CAS  PubMed  Google Scholar 

  88. Larson AN, Razonable RR, Hanssen AD (2009) Capnocytophaga canimorsus. A novel pathogen for joint arthroplasty. Clin Orthop Relat Res 467:1634–1638

    PubMed  Google Scholar 

  89. Le Moal G, Landron C, Grollier G, Robert R, Burucoa C (2003) Meningitis due to Capnocytophaga canimorsus after receipt of a dog bite: case report and review of the literature. Clin Infect Dis 36:e42–e46

    PubMed  Google Scholar 

  90. Linton DM, Potgieter PD, Roditi D, Phillips A, Adams BK, Hayhurst M, Knobel GJ (1994) Fatal Capnocytophaga canimorsus (DF-2) septicaemia. A case report. S Afr Med J 84:857–860

    CAS  PubMed  Google Scholar 

  91. Low SC-M, Greenwood JE (2008) Capnocytophaga canimorsus: infection, septicaemia, recovery and reconstruction. J Med Microbiol 57:901–903

    PubMed  Google Scholar 

  92. Ma A, Goetz MB (2013) Capnocytophaga canimorsus sepsis with associated thrombotic thrombocytopenic purpura. Am J Med Sci 345:78–80

    PubMed  Google Scholar 

  93. Malnick H, Adhami ZN, Galloway A (1991) Isolation and identification of Capnocytophaga canimorsus (DF-2) from blood culture. Lancet 338:384

    CAS  PubMed  Google Scholar 

  94. Mahrer S, Raik E (1992) Capnocytophaga canimorsus septicemia associated with cat scratch. Pathology 24:194–196

    CAS  PubMed  Google Scholar 

  95. Macrea MM, McNamee M, Martin TJ (2008) Acute onset of fever, chills, and lethargy in a 36-year-old woman. Chest 133:1505–1507

    PubMed  Google Scholar 

  96. Mardelle V, Vedy S, Dosseh G, Peytel E (2007) Choc septique à Capnocytophaga canimorsus. Ann Fran Anes Rean 26:617–618

    CAS  Google Scholar 

  97. Matulionytė R, Lisauskienė I, Kėkštas G, Ambrozaitis A (2012) Two dog-related infections leading to death: overwhelming Capnocytophaga canimorsus sepsis in a patient with cystic echinococcosis. Medicina (Kaunas) 48:112–115

    Google Scholar 

  98. McLean CR, Hargrove R, Behn E (2004) The first fatal case of Capnocytophaga canimorsus sepsis caused by a cat scratch. J R Nav Med Serv 90:13–15

    CAS  PubMed  Google Scholar 

  99. Mendioroz M, Moreno F, Marti I, Valiente A, Urtasun M, Martí-Massó JF (2002) Meningitis por Capnocytophaga canimorsus tras mordedura de perro. Rev Neurol 35:900

    CAS  PubMed  Google Scholar 

  100. Meybeck A, Aoun N, Granados D, Pease S, Yeni P (2006) Meningitis due to Capnocytophaga canimorsus: contribution of 16S RNA ribosomal sequencing for species identification. Scand J Infect Dis 38:375–379

    CAS  PubMed  Google Scholar 

  101. Mirza I, Wolk J, Toth L, Rostenberg P, Kranwinkel R, Sieber SC (2000) Waterhouse–Friderichsen syndrome secondary to Capnocytophaga canimorsus septicemia and demonstration of bacteremia by peripheral blood smear. A case report and review of the literature. Arch Pathol Lab Med 124:859–863

    CAS  PubMed  Google Scholar 

  102. Mitchell I, McNeillis N, Bowden FJ, Nikolic G (2002) Electrocardiographic myocardial infarction pattern in overwhelming post-splenectomy sepsis due to Capnocytophaga canimorsus. Intern Med J 32:415–418

    CAS  PubMed  Google Scholar 

  103. Monrad RN, Hansen DS (2012) Three cases of Capnocytophaga canimorsus meningitis seen at a regional hospital in one year. Scand J Infect Dis 44:320–324

    PubMed  Google Scholar 

  104. Morgan M (1994) Capnocytophaga canimorsus in peripheral blood smears. J Clin Pathol 47:681–682

    CAS  PubMed Central  PubMed  Google Scholar 

  105. Mulder AH, Gerlag PGG, Verhoef LHM, van den Wall Bake AWL (2001) Hemolytic uremic syndrome after capnocytophaga canimorsus (DF-2) septicemia. Clin Nephrol 55:167–170

    CAS  PubMed  Google Scholar 

  106. Ndon JA (1992) Capnocytophaga canimorsus septicemia caused by a dog bite in a hairy cell leukemia patient. J Clin Microbiol 30:211–213

    CAS  PubMed Central  PubMed  Google Scholar 

  107. Nelson MJ, Westfal RE (2008) Case report: Vertebral osteomyelitis/discitis as a complication of Capnocytophaga canimorsus bacteremia. J Emerg Med 35:269–271

    PubMed  Google Scholar 

  108. Ngaage DL, Kotidis KN, Sandoe JAT, Unnikrishnan Nair R (1999) Do not snog the dog: infective endocarditis due to Capnocytophaga canimorsus. Eur J Cardiothorac Surg 16:362–363

    CAS  PubMed  Google Scholar 

  109. O’Rourke GA, Rothwell R (2011) Capnocytophaga canimorsis a cause of septicaemia following a dog bite: a case review. Aust Crit Care 24:93–99

    PubMed  Google Scholar 

  110. Ota K, Kazawa T, Tsubata C, Suzuki M, Imaoka K (2009) An autopsy case involving severe sepsis due to Capnocytophaga canimorsus infection. Kansenshogaku Zasshi 83:661–664

    PubMed  Google Scholar 

  111. Papadaki TG, el Moussaoui R, van Ketel RJ, Verbraak FD, Tan HS (2008) Capnocytophaga canimorsus endogenous endophthalmitis in an immunocompetent host. Br J Ophthalmol 92:1566–1567

    CAS  PubMed  Google Scholar 

  112. Pedersen G, Schønheyder HC, Nielsen LC (1993) Capnocytophaga canimorsus bacteraemia demonstrated by a positive blood smear. A case report. APMIS 101:572–574

    CAS  PubMed  Google Scholar 

  113. Peel MM (1993) Dog-associated bacterial infections in humans: isolates submitted to an Australian reference laboratory, 1981–1992. Pathology 25:379–384

    CAS  PubMed  Google Scholar 

  114. Pers C, Gahrn-Hansen B, Frederiksen W (1996) Capnocytophaga canimorsus septicemia in Denmark, 1982–1995: review of 39 cases. Clin Infect Dis 23:71–75

    CAS  PubMed  Google Scholar 

  115. Phipps SE, Tamblyn DM, Badenoch PR (2002) Capnocytophaga canimorsus endophthalmitis following cataract surgery. Clin Experiment Ophthalmol 30:375–377

    PubMed  Google Scholar 

  116. Pletschette M, Köhl J, Kuipers J, Schmidt RE (1992) Opportunistic Capnocytophaga canimorsus infection. Lancet 339:308

    CAS  PubMed  Google Scholar 

  117. Popiel KY, Vinh DC (2013) ‘Bobo-Newton syndrome’: an unwanted gift from man’s best friend. Can J Infect Dis Med Microbiol 24:209–214

    PubMed Central  PubMed  Google Scholar 

  118. Rintala E, Kauppila M, Seppälä O-P, Voipio-Pulkki LM, Pettilä V, Rasi V, Kotilainen P (2000) Protein C substitution in sepsis-associated purpura fulminans. Crit Care Med 28:2373–2378

    CAS  PubMed  Google Scholar 

  119. Risi GF Jr, Spangler CA (2006) Capnocytophaga canimorsus meningitis after routine myelography: a sentinel event identifies multiple opportunities for improvement of standard practices in radiology. Am J Infect Control 34:540–542

    PubMed  Google Scholar 

  120. Risum M, Ellekvist P (2012) Capnocytophaga canimorsus-meningitis diagnosticeret ved hjaelp af 16S rRNA-analyse. Ugeskr Laeger 174:280–281

    PubMed  Google Scholar 

  121. Roblot P, Bazillou M, Grollier G, Becq-Giraudon B, Fauchère JL (1993) Septicemia due to Capnocytophaga canimorsus after a dog bite in a cirrhotic patient. Eur J Clin Microbiol Infect Dis 12:302–303

    CAS  PubMed  Google Scholar 

  122. Rosenman JR, Reynolds JK, Kleiman MB (2003) Capnocytophaga canimorsus meningitis in a newborn: an avoidable infection. Pediatr Infect Dis J 22:204–205

    PubMed  Google Scholar 

  123. Rossi P, Oger A, Bagneres D, Frances Y, Granel B (2009) Capnocytophaga canimorsus septicaemia in an asplenic patient with systemic lupus erythematosus. BMJ Case Rep. 2009. pii: bcr05.2009.1840

  124. Rougemont M, Ratib O, Wintsch J, Schrenzel J, Hirschel B (2013) Capnocytophaga canimorsus prosthetic aortitis in an HIV-positive woman. J Clin Microbiol 51:2769–2771

    PubMed Central  PubMed  Google Scholar 

  125. Ruddock TL, Rindler JM, Bergfeld WF (1997) Capnocytophaga canimorsus septicemia in an asplenic patient. Cutis 60:95–97

    CAS  PubMed  Google Scholar 

  126. Saab M, Corcoran JP, Southworth SA, Randall PE (1998) Fatal septicaemia in a previously healthy man following a dog bite. Int J Clin Pract 52:205

    CAS  PubMed  Google Scholar 

  127. Sacks R, Kerr K (2012) A 42-year-old woman with septic shock: an unexpected source. J Emerg Med 42:275–278

    PubMed  Google Scholar 

  128. Sawmiller CJ, Dudrick SJ, Hamzi M (1998) Postsplenectomy Capnocytophaga canimorsus sepsis presenting as an acute abdomen. Arch Surg 133:1362–1365

    CAS  PubMed  Google Scholar 

  129. Scarlett JD, Williamson HG, Dadson PJ, Fassett R, Peel MM (1991) A syndrome resembling thrombotic thrombocytopenic purpura associated with Capnocytophaga canimorsus septicemia. Am J Med 90:127–128

    CAS  PubMed  Google Scholar 

  130. Shahani L, Khardori N (2014) Overwhelming Capnocytophaga canimorsus infection in a patient with asplenia. BMJ Case Rep. doi:10.1136/bcr-2013-202768

    Google Scholar 

  131. Stiegler D, Gilbert JD, Warner MS, Byard RW (2010) Fatal dog bite in the absence of significant trauma: Capnocytophaga canimorsus infection and unexpected death. Am J Forensic Med Pathol 31:198–199

    PubMed  Google Scholar 

  132. Storgaard M (1992) Meningitis forarsaget af Capnocytophaga canimorsus med udvikling af erythema nodosum. Ugeskr Laeger 154:2437–2438

    CAS  PubMed  Google Scholar 

  133. Takahashi H, Deguchi Y, Abe M, Yamada S, Akizuki N, Kobayashi T, Nakagawa T (2009) A case who survived Capnocytophaga canimorsus sepsis with multiple organ failure. J Jpn Assoc Acute Med 20:226–231

    Google Scholar 

  134. Tan V, Schwartz JC (2014) Renal failure due to Capnocytophaga canimorsus generalized Shwartzman reaction from a dog bite (DF-2 nephropathy). Proc (Bayl Univ Med Cent) 27:139–140

    Google Scholar 

  135. Teo KG, Anavekar NS, Yazdabadi A, Ricketts S (2012) Asplenic fulminant sepsis secondary to a dog bite complicated by toxic epidermal necrolysis/Stevens–Johnson syndrome. N Z Med J 125:74–77

    PubMed  Google Scholar 

  136. Tobé TJM, Franssen CFM, Zijlstra JG, de Jong PE, Stegeman CA (1999) Hemolytic uremic syndrome due to Capnocytophaga canimorsus bacteremia after a dog bite. Am J Kidney Dis 33:e5

    PubMed  Google Scholar 

  137. Tuuminen T, Viiri H, Vuorinen S (2014) The Capnocytophaga canimorsus isolate that caused sepsis in an immunosufficient man was transmitted by the large pine weevil Hylobius abietis. J Clin Microbiol 52:2716–2717

    PubMed Central  PubMed  Google Scholar 

  138. Ugai T, Sugihara H, Nishida Y, Yamakura M, Takeuchi M, Matsue K (2014) Capnocytophaga canimorsus sepsis following BMT in a patient with AML: possible association with functional asplenia. Bone Marrow Transplant 49:153–154

    CAS  PubMed  Google Scholar 

  139. Ulivieri S, Oliveri G, Filosomi G (2008) A case of Capnocytophaga canimorsus brain abscess secondary to dog’s bite. G Chir 29:79–80

    CAS  PubMed  Google Scholar 

  140. Valtonen M, Lauhio A, Carlson P, Multanen J, Sivonen A, Vaara M, Lähdevirta J (1995) Capnocytophaga canimorsus septicemia: fifth report of a cat-associated infection and five other cases. Eur J Clin Microbiol Infect Dis 14:520–523

    CAS  PubMed  Google Scholar 

  141. van Dam AP, Jansz A (2011) Capnocytophaga canimorsus infections in The Netherlands: a nationwide survey. Clin Microbiol Infect 17:312–315

    PubMed  Google Scholar 

  142. van de Ven ART, van Vliet ACM, Maraha B, Ponssen HH (2004) Fibrinolytic therapy in Capnocytophaga canimorsus sepsis after dog bite. Intensive Care Med 30:1980. doi:10.1007/s00134-004-2387-1

    PubMed  Google Scholar 

  143. Van der Klooster JM, Grootendorst AF (2002) Capnocytophaga canimorsus sepsis in an immune-competent patient: tiny dog, major sepsis. Neth J Med 60:186–187

    PubMed  Google Scholar 

  144. Vanhonsebrouck AY, Gordts B, Wauters G, Van Landuyt HW (1991) Fatal septicemia with Capnocytophaga canimorsus in a compromised host. A case report with review of the literature. Acta Clin Belg 46(6):364–370

    CAS  PubMed  Google Scholar 

  145. Völl K, Haase G, Fritz H, Riebe J, Huszka C, Kindler J (2007) Sepsis mit purpura fulminans nach hundebiss. Dtsch Med Wochenschr 132:1321–1324

    PubMed  Google Scholar 

  146. Wald K, Martinez A, Moll S (2008) Capnocytophaga canimorsus infection with fulminant sepsis in an asplenic patient: diagnosis by review of peripheral blood smear. Am J Hematol 83:879

    PubMed  Google Scholar 

  147. Wareham DW, Michael JS, Warwick S, Whitlock P, Wood A, Das SS (2007) The dangers of dog bites. J Clin Pathol 60:328–329

    PubMed Central  PubMed  Google Scholar 

  148. Widlund M, Duberg A-S (2010) Hundbett gav kvarstaende dovhet. Capnocytophaga canimorsus orsakade allvarlig infection med sepsis. Lakartidningen 107:1771–1773

    PubMed  Google Scholar 

  149. Yu RK, Shepherd LE, Rapson DA (2000) Capnocytophaga canimorsus, a potential emerging microorganism in splenectomized patients. Br J Haematol 109:679

    CAS  PubMed  Google Scholar 

  150. Zimmer-Galler IE, Pach JM (1996) Capnocytophaga canimorsus endophthalmitis. Retina 16:163–164

    CAS  PubMed  Google Scholar 

  151. Social Science Statistics. Mann-Whitney U-value Calculator. Available online at: http://www.socscistatistics.com/tests/mannwhitney/. Accessed 29 June 2014

  152. Bailie WE, Stowe EC, Schmitt AM (1978) Aerobic bacterial flora of oral and nasal fluids of canines with reference to bacteria associated with bites. J Clin Microbiol 7:223–231

    CAS  PubMed Central  PubMed  Google Scholar 

  153. Dilegge SK, Edgcomb VP, Leadbetter ER (2011) Presence of the oral bacterium Capnocytophaga canimorsus in the tooth plaque of canines. Vet Microbiol 149:437–445

    CAS  PubMed  Google Scholar 

  154. Westwell AJ, Kerr K, Spencer MB, Hutchinson DN (1989) DF-2 infection. BMJ 298:116–117

    CAS  PubMed Central  PubMed  Google Scholar 

  155. Lipman L, Tienhoven N, Gaastr W (2011) De aanwezigheid van Capnocytophaga canimorsus en Capnocytophaga cynodegmi bij gezelschapdieren in Nederland. Tijdschr Diergeneeskd 136:490–492

    CAS  PubMed  Google Scholar 

  156. van Dam AP, van Weert A, Harmanus C, Hovius KE, Claas ECJ, Reubsaet FA (2009) Molecular characterization of Capnocytophaga canimorsus and other canine Capnocytophaga spp. and assessment by PCR of their frequencies in dogs. J Clin Microbiol 47:3218–3125

    PubMed Central  PubMed  Google Scholar 

  157. Blanche P, Bloch E, Sicard D (1998) Capnocytophaga canimorsus in the oral flora of dogs and cats. J Infect 36:134

    CAS  PubMed  Google Scholar 

  158. Mally M, Paroz C, Shin H, Meyer S, Soussoula LV, Schmiediger U, Saillen-Paroz C, Cornelis GR (2009) Prevalence of Capnocytophaga canimorsus in dogs and occurrence of potential virulence factors. Microbes Infect 11:509–514

    CAS  PubMed  Google Scholar 

  159. Suzuki M, Kimura M, Imaoka K, Yamada A (2010) Prevalence of Capnocytophaga canimorsus and Capnocytophaga cynodegmi in dogs and cats determined by using a newly established species-specific PCR. Vet Microbiol 144:172–176

    CAS  PubMed  Google Scholar 

  160. Butler T, Johnston KH, Gutierrez Y, Aikawa M, Cardaman R (1985) Enhancement of experimental bacteremia and endocarditis caused by dysgonic fermenter (DF-2) bacterium after treatment with methylprednisolone and after splenectomy. Infect Immun 47:294–300

    CAS  PubMed Central  PubMed  Google Scholar 

  161. Shin H, Mally M, Meyer S, Fiechter C, Paroz C, Zaehringer U, Cornelis GR (2009) Resistance of Capnocytophaga canimorsus to killing by human complement and polymorphonuclear leukocytes. Infect Immun 77:2262–2271

    CAS  PubMed Central  PubMed  Google Scholar 

  162. Renzi F, Manfredi P, Mally M, Moes S, Jenö P, Cornelis GR (2011) The N-glycan glycoprotein deglycosylation complex (Gpd) from Capnocytophaga canimorsus deglycosylates human IgG. PLoS Pathog 7:e1002118

    CAS  PubMed Central  PubMed  Google Scholar 

  163. Mally M, Shin H, Paroz C, Landmann R, Cornelis GR (2008) Capnocytophaga canimorsus: a human pathogen feeding at the surface of epithelial cells and phagocytes. PLoS Pathog 4:e1000164

    PubMed Central  PubMed  Google Scholar 

  164. Frieling JTM, Mulder JA, Hendriks T, Curfs JHAJ, van der Linden CJ, Sauerwein RW (1997) Differential induction of pro- and anti-inflammatory cytokines in whole blood by bacteria: effects of antibiotic treatment. Antimicrob Agents Chemother 41:1439–1443

    CAS  PubMed Central  PubMed  Google Scholar 

  165. Shin H, Mally M, Kuhn M, Paroz C, Cornelis GR (2007) Escape from immune surveillance by Capnocytophaga canimorsus. J Infect Dis 195:375–386

    CAS  PubMed  Google Scholar 

  166. Fischer LJ, Weyant RS, White EH, Quinn FD (1995) Intracellular multiplication and toxic destruction of cultured macrophages by Capnocytophaga canimorsus. Infect Immun 63:3484–3490

    CAS  PubMed Central  PubMed  Google Scholar 

  167. Ittig S, Lindner B, Stenta M, Manfredi P, Zdorovenko E, Knirel YA, dal Peraro M, Cornelis GR, Zähringer U (2012) The lipopolysaccharide from Capnocytophaga canimorsus reveals an unexpected role of the core-oligosaccharide in MD-2 binding. PLoS Pathog 8:e1002667

    CAS  PubMed Central  PubMed  Google Scholar 

  168. Hasin DS, Stinson FS, Ogburn E, Grant BF (2007) Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry 64:830–842

    PubMed  Google Scholar 

  169. Sumaraju V, Smith LG, Smith SM (2001) Infectious complications in asplenic hosts. Infect Dis Clin North Am 15:551–565

    CAS  PubMed  Google Scholar 

  170. Weber DJ, Hansen AR (1991) Infections resulting from animal bites. Infect Dis Clin North Am 5:663–680

    CAS  PubMed  Google Scholar 

  171. Oehler RL, Velez AP, Mizrachi M, Lamarche J, Gompf S (2009) Bite-related and septic syndromes caused by cats and dogs. Lancet Infect Dis 9:439–447

    PubMed  Google Scholar 

  172. Ge Y, Ezzell RM, Tompkins RG, Warren HS (1994) Cellular distribution of endotoxin after injection of chemically purified lipopolysaccharide differs from that after injection of live bacteria. J Infect Dis 169:95–104

    CAS  PubMed  Google Scholar 

  173. Lu M, Munford RS (2011) The transport and inactivation kinetics of bacterial lipopolysaccharide influence its immunological potency in vivo. J Immunol 187:3314–3320

    CAS  PubMed Central  PubMed  Google Scholar 

  174. Okabayashi T, Hanazaki K (2008) Overwhelming postsplenectomy infection syndrome in adults-a clinically preventable disease. World J Gastroenterol 14:176–179

    PubMed Central  PubMed  Google Scholar 

  175. Corazza GR, Addolorato G, Biagi F, Caputo F, Castelli E, Stefanini GF, Gasbarrini G (1997) Splenic function and alcohol addiction. Alcohol Clin Exp Res 21:197–200

    CAS  PubMed  Google Scholar 

  176. Satapathy SK, Narayan S, Varma N, Dhiman RK, Varma S, Chawla Y (2001) Hyposplenism in alcoholic cirrhosis, facts or artifacts? A comparative analysis with non-alcoholic cirrhosis and extrahepatic portal venous obstruction. J Gastroenterol Hepatol 16:1038–1043

    CAS  PubMed  Google Scholar 

  177. Wilson BA, Ho M (2013) Pasteurella multocida: from zoonosis to cellular microbiology. Clin Microbiol Rev 26:631–655

    CAS  PubMed Central  PubMed  Google Scholar 

Download references

Conflict of interest

The author declares that he has no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Microbiology and Immunology, Ross University School of Medicine, Portsmouth, Dominica, West Indies

    T. Butler

  2. 485 US Highway 1 South, Building B 4th Floor, Iselin, NJ, 08830, USA

    T. Butler

Authors
  1. T. Butler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T. Butler.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Butler, T. Capnocytophaga canimorsus: an emerging cause of sepsis, meningitis, and post-splenectomy infection after dog bites. Eur J Clin Microbiol Infect Dis 34, 1271–1280 (2015). https://doi.org/10.1007/s10096-015-2360-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-015-2360-7

Keywords

  • Meningitis
  • Disseminate Intravascular Coagulation
  • Colistin
  • Hemolytic Uremic Syndrome
  • Thrombotic Thrombocytopenic Purpura