• B Kleijnen-Grebien, S Boorsma, F S Stals, and R van Schelven.
• Laurentius Ziekenhuis, Roermond. bkleijnen@yahoo.com
• Ned Tijdschr Geneeskd. 2008 Aug 23;152(34):1882-5.

AbstractA healthy 54-year-old man presented at the emergency department with signs of sepsis. Four days prior he was bitten and scratched by his dog. Microscopy of the blood smear showed intracellular Gram-negative rods. Despite maximal treatment the patient died a day and a half after admission due to septic shock with multi-organ failure and disseminated intravascular coagulopathy. After extended incubation of the spleen culture a Gram-negative rod was isolated and identified as Capnocytophaga canimorsus based on 16s RNA analysis. This is a commensal microorganism found in the oropharynx of dogs and cats. Infection occurs 2-3 days after contamination. The clinical presentation is heterogeneous, and contamination can sometimes proceed to fulminant infection. The lethality of infection is 30%. A risk factor is often present, such assplenectomy, alcohol abuse or immunosuppression. Immediate antibiotic treatment may influence the course of infection. Antibiotic prophylaxis has also been proposed for high-risk patients with dog bites.

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