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Severe sepsis caused by Capnocytophaga canimorsus complicated by thrombotic microangiopathy in an immunocompetent patient

CASE: A 61‐year‐old man with an unremarkable medical history was admitted with fever 7 days after being bitten by his dog. On day 3, he showed altered mental status, and laboratory data showed progressive hemolytic anemia, thrombocytopenia, hyperbilirubinemia, renal dysfunction, coagulopathy, and sc...

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Autores principales: Maezawa, Shota, Kudo, Daisuke, Asanuma, Keiichiro, Takekoshi, Daisuke, Egashira, Ryuichiro, Kushimoto, Shigeki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5667302/
https://www.ncbi.nlm.nih.gov/pubmed/29123842
http://dx.doi.org/10.1002/ams2.222
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author Maezawa, Shota
Kudo, Daisuke
Asanuma, Keiichiro
Takekoshi, Daisuke
Egashira, Ryuichiro
Kushimoto, Shigeki
author_facet Maezawa, Shota
Kudo, Daisuke
Asanuma, Keiichiro
Takekoshi, Daisuke
Egashira, Ryuichiro
Kushimoto, Shigeki
author_sort Maezawa, Shota
collection PubMed
description CASE: A 61‐year‐old man with an unremarkable medical history was admitted with fever 7 days after being bitten by his dog. On day 3, he showed altered mental status, and laboratory data showed progressive hemolytic anemia, thrombocytopenia, hyperbilirubinemia, renal dysfunction, coagulopathy, and schistocytosis. Severe sepsis complicated with thrombotic microangiopathy caused by Capnocytophaga canimorsus was suspected. OUTCOME: Plasma exchange was applied to treat the thrombotic microangiopathy and resulted in platelet count increase and improved renal function, hyperbilirubinemia, and schistocytosis. Blood culture results confirmed the presence of C. canimorsus. The patient was discharged in good condition. CONCLUSION: Capnocytophaga canimorsus is rare cause of severe sepsis, and should be suspected even in immunocompetent patients with dog‐bite history. Capnocytophaga canimorsus infection may be complicated by thrombotic microangiopathy, for which plasma exchange should be considered prior to definitive diagnosis of thrombotic microangiopathy.
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spelling pubmed-56673022017-11-09 Severe sepsis caused by Capnocytophaga canimorsus complicated by thrombotic microangiopathy in an immunocompetent patient Maezawa, Shota Kudo, Daisuke Asanuma, Keiichiro Takekoshi, Daisuke Egashira, Ryuichiro Kushimoto, Shigeki Acute Med Surg Case Reports CASE: A 61‐year‐old man with an unremarkable medical history was admitted with fever 7 days after being bitten by his dog. On day 3, he showed altered mental status, and laboratory data showed progressive hemolytic anemia, thrombocytopenia, hyperbilirubinemia, renal dysfunction, coagulopathy, and schistocytosis. Severe sepsis complicated with thrombotic microangiopathy caused by Capnocytophaga canimorsus was suspected. OUTCOME: Plasma exchange was applied to treat the thrombotic microangiopathy and resulted in platelet count increase and improved renal function, hyperbilirubinemia, and schistocytosis. Blood culture results confirmed the presence of C. canimorsus. The patient was discharged in good condition. CONCLUSION: Capnocytophaga canimorsus is rare cause of severe sepsis, and should be suspected even in immunocompetent patients with dog‐bite history. Capnocytophaga canimorsus infection may be complicated by thrombotic microangiopathy, for which plasma exchange should be considered prior to definitive diagnosis of thrombotic microangiopathy. John Wiley and Sons Inc. 2016-05-23 /pmc/articles/PMC5667302/ /pubmed/29123842 http://dx.doi.org/10.1002/ams2.222 Text en © 2016 The Authors Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Case Reports
Maezawa, Shota
Kudo, Daisuke
Asanuma, Keiichiro
Takekoshi, Daisuke
Egashira, Ryuichiro
Kushimoto, Shigeki
Severe sepsis caused by Capnocytophaga canimorsus complicated by thrombotic microangiopathy in an immunocompetent patient
title Severe sepsis caused by Capnocytophaga canimorsus complicated by thrombotic microangiopathy in an immunocompetent patient
title_full Severe sepsis caused by Capnocytophaga canimorsus complicated by thrombotic microangiopathy in an immunocompetent patient
title_fullStr Severe sepsis caused by Capnocytophaga canimorsus complicated by thrombotic microangiopathy in an immunocompetent patient
title_full_unstemmed Severe sepsis caused by Capnocytophaga canimorsus complicated by thrombotic microangiopathy in an immunocompetent patient
title_short Severe sepsis caused by Capnocytophaga canimorsus complicated by thrombotic microangiopathy in an immunocompetent patient
title_sort severe sepsis caused by capnocytophaga canimorsus complicated by thrombotic microangiopathy in an immunocompetent patient
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5667302/
https://www.ncbi.nlm.nih.gov/pubmed/29123842
http://dx.doi.org/10.1002/ams2.222
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