Capnocytophaga canimorsus Sepsis With Associated Thrombotic Thrombocytopenic Purpura

Abstract

Capnocytophaga canimorsus, a bacterium commonly transmitted via dog bites, is known to cause sepsis in immunocompromised patients. Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome are rare complications of infection. We present a case of C. canimorsus sepsis and thrombotic thrombocytopenic purpura in an asplenic patient and review the relevant literature.

Secondary thrombotic microangiopathy with severely reduced ADAMTS13 activity in a patient with Capnocytophaga canimorsus sepsis: a case report

“…Multiple case reports have also described TTP/hemolytic uremic syndrome–like illnesses complicating C. canimorsus sepsis. In these cases, the given therapy consisted of either plasma combined or plasma‐combined with high‐dose steroids …”

Capnocytophaga canimorsus bacteremia: clinical features and outcomes from a Helsinki ICU cohort

“…14 In our study, the maximal SOFA score was relatively high and the highest score was reached on the first day in all patients. 16 We cannot exclude undiagnosed TTP as a cause of thrombocytopenia in our patients. Thrombocytopenia is frequently associated with septic shock, with an incidence of >50% and has an association with increased mortality.…”

“…11 There are case reports of thrombotic thrombocytopenic purpura (TTP) in association with C. canimorsus infections. 16 We cannot exclude undiagnosed TTP as a cause of thrombocytopenia in our patients. The second most common organ dysfunction was acute kidney injury (AKI).…”

Double zoonotic peritonitis

“…They are part of the normal flora of dogs and cats, canines, rabbits and human beings. They are of low virulence for healthy human beings but they can cause severe infections in immunocompromised hosts including, cellulitis, sepsis, thrombotic thrombocytpenic purpura [6], infectious purpura fulminans [7] osteomyelitis, abscesses, meningitis [8], endocarditis, keratitis, chorioamnionitis and neonatal infection. Patients with history of alcoholism, splenectomy, asplenia, pregnancy and young children, are at high risk for serious complications after exposure to C. canimorsus .…”