Fulminant Sepsis Following a Minor Dog Bite in an Asplenic Patient

Öz

ABSTRACT Introduction: Capnocytophaga species are fastidious gram-negative bacilli found in the oral flora of dogs and cats that can cause fulminant sepsis, particularly in asplenic individuals.1–3 Infection may occur even in the absence of overt wound infection, leading to delayed recognition and high mortality. Case Report: A 71-year-old asplenic man presented to the emergency department with altered mental status, hypotension, and fever three days after a minor dog bite with no local signs of infection. Initial laboratory evaluation demonstrated lactic acidosis, acute kidney injury, markedly elevated procalcitonin, and peripheral smear findings consistent with functional asplenia and overwhelming bacteremia. Despite early resuscitation and empiric antibiotics, the patient developed septic shock with multisystem organ failure, severe thrombocytopenia, purpura fulminans, and required mechanical ventilation and vasopressor support. Blood cultures later grew Capnocytophaga species. He ultimately recovered and was discharged neurologically intact. Conclusion: This case highlights the rapid progression and severity of Capnocytophaga infections in asplenic patients, even after minor animal exposures. Peripheral smear abnormalities and early recognition are critical to prompt management and survival. 1. Centers for Disease Control and Prevention. Clinical Overview of Capnocytophaga. Updated August 26, 2025. Accessed January 26, 2026. https://www.cdc.gov/capnocytophaga/hcp/clinical-overview/index.html?utm_source 2. Centers for Disease Control and Prevention. About Capnocytophaga. Updated August 26, 2025. Accessed January 26, 2026. https://www.cdc.gov/capnocytophaga/about/index.html?utm_source 3. Bobo RA, Newton EJ, Paradise MW. Capnocytophaga canimorsus: an emerging cause of sepsis, meningitis, and post-splenectomy infection after dog bites. Clin Infect Dis. 2015;61(9):1479-1488. 4. Deshmukh PM, Camp CJ, Rose FB, Narayanan S. Capnocytophaga canimorsus sepsis with purpura fulminans and symmetrical gangrene following a dog bite in a shelter employee. Am J Med Sci. 2004;327(6):369-372. 5. O’Rourke GA, Rothwell R. Capnocytophaga as a cause of septicaemia following a dog bite: a case review. Aust Crit Care. 2011;24(2):93-99. 6. Depres-Brummer P, Buijs J, van Engelenburg KC, Oosten HR. Capnocytophaga sepsis presenting as an acute abdomen in an asplenic patient. Neth J Med. 2001;59(5):213-217. 7. Nakayama R, Miyamoto S, Tawara T, et al. Capnocytophaga canimorsus infection led to progressively fatal septic shock in an immunocompetent patient. Acute Med Surg. 2022;9(1):e738. 8. Purpura fulminans and septic shock due to Capnocytophaga after dog bite: a case report and review of the literature. J Infect. 2018;77(3):260-264. 9. Christiansen CB, Berg RM, Plovsing RR, Møller K. Two cases of infectious purpura fulminans and septic shock caused by Capnocytophaga canimorsus transmitted from dogs. Scand J Infect Dis. 2012;44(8):635-639.

Anahtar Kelimeler

• Capnocytophaga species
• Dog bite
• Asplenia
• sepsis

Kaynakça

1. 1. Centers for Disease Control and Prevention. Clinical Overview of Capnocytophaga. Updated August 26, 2025. Accessed January 26, 2026. https://www.cdc.gov/capnocytophaga/hcp/clinical-overview/index.html?utm_source
2. 2. Centers for Disease Control and Prevention. About Capnocytophaga. Updated August 26, 2025. Accessed January 26, 2026. https://www.cdc.gov/capnocytophaga/about/index.html?utm_source
3. 3. Bobo RA, Newton EJ, Paradise MW. Capnocytophaga canimorsus: an emerging cause of sepsis, meningitis, and post-splenectomy infection after dog bites. Clin Infect Dis. 2015;61(9):1479-1488.
4. 4. Dąbrowska ZB, Symula B, Jermakow K. Blood infection of Capnocytophaga canimorsus etiology following a dog bite: case report and review of the available literature. Przegl Epidemiol. 2024;78(2):167-176.
5. 5. Deshmukh PM, Camp CJ, Rose FB, Narayanan S. Capnocytophaga canimorsus sepsis with purpura fulminans and symmetrical gangrene following a dog bite in a shelter employee. Am J Med Sci. 2004;327(6):369-372.
6. 6. O’Rourke GA, Rothwell R. Capnocytophaga as a cause of septicaemia following a dog bite: a case review. Aust Crit Care. 2011;24(2):93-99.
7. 7. Depres-Brummer P, Buijs J, van Engelenburg KC, Oosten HR. Capnocytophaga sepsis presenting as an acute abdomen in an asplenic patient. Neth J Med. 2001;59(5):213-217.
8. 8. Nakayama R, Miyamoto S, Tawara T, et al. Capnocytophaga canimorsus infection led to progressively fatal septic shock in an immunocompetent patient. Acute Med Surg. 2022;9(1):e738.

9. 9. Purpura fulminans and septic shock due to Capnocytophaga after dog bite: a case report and review of the literature. J Infect. 2018;77(3):260-264.
10. 10. Christiansen CB, Berg RM, Plovsing RR, Møller K. Two cases of infectious purpura fulminans and septic shock caused by Capnocytophaga canimorsus transmitted from dogs. Scand J Infect Dis. 2012;44(8):635-639.