1. Severe sepsis caused by Capnocytophaga canimorsus complicated by thrombotic microangiopathy in an immunocompetent patient
- Author
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Shigeki Kushimoto, Keiichiro Asanuma, Daisuke Takekoshi, Shota Maezawa, Daisuke Kudo, and Ryuichiro Egashira
- Subjects
Hemolytic anemia ,medicine.medical_specialty ,Thrombotic microangiopathy ,Renal function ,Case Report ,Case Reports ,030204 cardiovascular system & hematology ,dog bite ,Gastroenterology ,sepsis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Coagulopathy ,Capnocytophaga canimorsus ,Medical history ,Platelet ,Blood culture ,030212 general & internal medicine ,biology ,medicine.diagnostic_test ,business.industry ,General Engineering ,biology.organism_classification ,medicine.disease ,Surgery ,Acute kidney injury ,thrombotic microangiopathy ,business - Abstract
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.
- Published
- 2016