Cat Rearing: A Potential Risk of Fulminant Sepsis Caused by Capnocytophaga canimorsus in a Hemodialysis Patient

Capnocytophaga canimorsus is a commensal organism colonized in oral flora of dogs and cats and causes severe sepsis through bite wound in immunocompromised patients. To date, hemodialysis has not been reported as a risk of C. canimorsus infection. A 75-year-old woman with end-stage renal disease secondary to hypertension suddenly developed septic shock. She reared 6 cats in her home, but no bite or scratch wound was found on her body. She was empirically treated with piperacillin-tazobactam and temporally received continuous hemodiafiltration. On the fifth day after sampling, blood culture revealed C. canimorsus as the cause of sepsis. After 4 weeks of antibiotic therapy targeting this organism, she recovered from the sepsis and was discharged on the 109th hospitalization day. Hemodialysis patients may be vulnerable to invasion into the blood stream by C. canimorsus due to the presence of punctures in their skin and the impaired immune function associated with uremia. Physicians should consider this organism as a cause of sepsis in hemodialysis patients who rear dogs or cats even in the absence of apparent bite wounds.