Septic shock caused by Capnocytophaga canis after a cat scratch
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BRIEF REPORT
Septic shock caused by Capnocytophaga canis after a cat scratch Viviane Donner 1 & Marta Buzzi 1 & Vladimir Lazarevic 2 & Nadia Gaïa 2 & Myriam Girard 2 & Francesco Renzi 3 & Gesuele Renzi 4 & Abdessalam Cherkaoui 4 & Jacques Schrenzel 1,2,4 Received: 17 February 2020 / Accepted: 1 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Capnocytophaga canis is an uncommon cause of septic shock. Only three cases have been previously reported in the literature. In this article, we describe the case of a 70-year-old male admitted to the intensive care unit for septic shock of unknown origin. On day 2, one anaerobic bottle out of the two sets taken at admission turned positive with Gram-negative bacilli. The pathogen was identified by 16S rRNA gene as C. canis. The strain was characterized and compared with other clinical isolates of Capnocytophaga spp. Keywords Asplenia . Sepsis . Capsule . Capnocytophaga . Whole-genome sequencing . Zoonosis
Case report A 70-year-old male presented with complaints of malaise, fever with chills, and shortness of breath evolving for 6 h as well as a worsened lumbar pain. His medical history was relevant for chronic lumbar pain, permanent atrial fibrillation, and chronic alcohol consumption. He had several episodes of acute complicated pancreatitis in the past. At the age of 57, he underwent a partial pancreatectomy with splenectomy for a complicated pancreatic pseudocyst. His vaccination status was not up-to-date. Vital signs on admission were as follows: blood pressure 90/60 mmHg, pulse rate 130 bpm irregular, respiratory rate 15/min, percutaneous oxygen saturation 94%, and temperature 40.2 °C. The clinical examination indicated a mottled skin and diffuse lumbar pain without focal pain or neurological defect. Laboratory test results revealed a mild leucopenia
(3.7 × 109/L) with 15% band forms, a mildly elevated Creactive protein (20.4 mg/mL), and high procalcitonin level (> 100 μg/L). Coagulation tests showed a decreased prothrombin time (29%), prolonged partial thromboplastin time (67%), and low fibrinogen (1.8 g/L) with preserved factor V activity (100%). The patient received a single empirical dose of 2 g of ceftriaxone in the prehospital setting due to the fever and his asplenic condition. Shortly after his arrival in the emergency department, blood cultures were drawn and empirical treatment with piperacillin-tazobactam for septic shock of unknown origin was administered. A computed thoracoabdominal tomography scan performed that same day showed a left periureteral infiltration without signs of renal obstruction, and some enlarged mesenteric lymph nodes. There was no sign of spondylodiscitis.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10096-020-03922-8) contains supplementary material, which is available to authorized users.
Clinical course
* Jacques Schrenzel [email protected] 1
Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, University of
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