Rare case of Capnocytophaga canimorsus meningitis in a man without risk factors

2021 ◽  
Vol 14 (5) ◽  
pp. e241686
Author(s):  
Faheem Malik ◽  
William Orchard ◽  
George Jacob
Keyword(s):  
Risk Factors ◽  
Rare Case ◽  
Immunocompetent Patient ◽  
Clinical Suspicion ◽  
Dog Bite ◽  
Capnocytophaga Canimorsus ◽  
Animal Exposure

Capnocytophaga canimorsus meningitis is an uncommon but potentially serious cause of meningitis, which is considered particularly rare in healthy and immunocompetent individuals. We present a case of C. canimorsus meningitis in a young, immunocompetent patient which was acquired following a dog bite. We review the literature and propose that underdiagnosis of this condition is likely. To avoid misdiagnosis, and thus improper management, clinicians should ensure that they identify animal exposure in all meningitic patients, and adopt a higher clinical suspicion in the absence of classical risk factors.

scholarly journals Capnocytophaga canimorsus Bloodstream Infection Associated with an Urticarial Exanthem

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
John C. Goetzinger ◽  
Austin L. LaGrow ◽  
Dena R. Shibib ◽  
Sharanjeet K. Thind
Keyword(s):  
Risk Factors ◽  
Clinical Course ◽  
Immunocompetent Patient ◽  
Dog Bite ◽  
Capnocytophaga Canimorsus ◽  
Gram Negative ◽  
Patient Reported ◽  
History Of ◽  
Biochemical Testing

Background. Capnocytophaga canimorsus is a fastidious, slow-growing, Gram-negative rod that is a commensal bacterium in normal gingival flora of canine and feline species. Infection with the organism may cause disease ranging from flu-like symptoms to disseminated intravascular coagulation (DIC), fulminant sepsis, meningitis, and endocarditis with an overall fatality rate of 6–26%. Risk factors for infection from C. canimorsus include immunosuppression, alcoholism, and asplenia. Case Presentation. We describe an unusual case with a relatively indolent clinical course and an urticarial exanthem in an otherwise young immunocompetent patient with a history of type 1 diabetes. The patient presented to the Emergency Department (ED) with a <1-day history of rhinorrhea, fever, and dyspnea. He met sepsis criteria on initial presentation, but left against medical advice and returned to the ED the following day, with new arthralgias and a diffuse rash, multiple erythematous, tender macules scattered across his trunk and extremities, and tonsillar erythema. He had not taken the doses of the prescribed amoxicillin. Blood cultures two days later signaled positive for growth with the Gram stain showing a Gram-negative rod. Three 7-8 cm tender targetoid lesions with central clearing were identified on the patient’s back. The patient reported two nonengorged ticks crawling on his body a week prior and sustaining a dog bite to his ear three weeks before presentation. Ultimately, the organism was identified as C. canimorsus through MALDI-TOF mass spectrometry and additional biochemical testing. He was given appropriate antibiotics and improved clinically thereafter. Despite the patient’s bacteremia, he never progressed to fulminant sepsis and followed a mild clinical course with several unusual characteristics. C. canimorsus is an uncommon cause of illness in humans, but is an important pathogen to consider when evaluating a patient with a dog bite, known risk factors, and an urticarial exanthem as empiric treatment may prevent severe outcomes.

A Rare Case of Tuberculous Prostatitis

2016 ◽  
Vol 1 (2) ◽  
pp. 33
Author(s):  
Nurul Yaqeen Mohd Esa ◽  
Mohammad Hanafiah ◽  
Marymol Koshy ◽  
Hilmi Abdullah ◽  
Ahmad Izuanuddin Ismail ◽  
...  
Keyword(s):  
Rare Case ◽  
Correct Diagnosis ◽  
Immunocompetent Patient ◽  
Clinical Suspicion ◽  
Tuberculosis Infection ◽  
Advanced Age ◽  
Immunocompromised Patients ◽  
Prostatic Biopsy ◽  
High Clinical Suspicion

Tuberculous prostatitis is an uncommon form of tuberculosis infection. It is commonly seen in immunocompromised patients and in those of middle or advanced age. The diagnosis is often not straight forward due to the nature of its presentation. We report a case of tuberculous prostatitis in a young, healthy and immunocompetent patient, who initially presented with respiratory features, followed by episodes of seizures and testicular swelling. He was finally diagnosed with tuberculous prostatitis after prostatic biopsy. This case illustrates that in a high TB prevalence environment, when symptoms warrant, there should be a high clinical suspicion coupled with a thorough approach in order to arrive at a correct diagnosis of TB prostatitis.

scholarly journals ‘Bobo-Newton Syndrome’: An Unwanted Gift from Man’s Best Friend

2013 ◽  
Vol 24 (4) ◽  
pp. 209-214 ◽  
Author(s):  
Kristin Y Popiel ◽  
Donald C Vinh
Keyword(s):  
Present Article ◽  
Invasive Disease ◽  
Clinical Suspicion ◽  
Genetic Identification ◽  
Dog Bite ◽  
Capnocytophaga Canimorsus ◽  
Oral Flora ◽  
Blood Isolate ◽  
Negative Bacillus ◽  
Clinical Syndromes

Capnocytophaga canimorsusis a facultative Gram-negative bacillus that is typically a constituent of the oral flora of dogs and cats. It was first isolated by Bobo and Newton in 1976 from a man presenting with meningitis following a dog bite. Transmission to humans follows various animal-related injuries, which may be gross or subtle.C canimorsuscan cause a spectrum of syndromes ranging from skin and soft tissue infection to invasive disease such as meningitis or endocarditis. The present article reports a case ofC canimorsusmeningitis in a patient with the classic risk factor of alcoholic liver cirrhosis. Clinical suspicion was confirmed by culture and genetic identification of the blood isolate. The present article reviews theCapnocytophagagenus, the clinical syndromes most commonly associated with this zoonotic organism, its laboratory identification and treatment.

A rare case of Waterhouse-Friderichsen syndrome caused by Capnocytophaga canimorsus in an immunocompetent patient

Infection ◽  
2015 ◽  
Vol 43 (5) ◽  
pp. 599-602 ◽  
Author(s):  
Joseph David Cooper ◽  
Robert Patrick Dorion ◽  
Joseph Lorenzo Smith
Keyword(s):  
Rare Case ◽  
Immunocompetent Patient ◽  
Capnocytophaga Canimorsus

scholarly journals A Case of Capnocytophaga Canimorsus Meningitis in Immunocompetent Host: A Zoonotic Agent in the Lombardian Alpes in Italy

2021 ◽  
Vol 2 (10) ◽  
pp. 902-904
Author(s):  
Rocco Galimi
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Human Infection ◽  
Clinical Suspicion ◽  
History Taking ◽  
Immunocompetent Host ◽  
Capnocytophaga Canimorsus ◽  
Neurological Sequelae

The author reports the case of C. canimorsus meningitis consecutive to Capnocytophaga canimorsus infection in a 51-year-old man. Human infection is rare but can lead to devastating outcomes. In patients in whom shortly after a dog or cat bite symptoms of meningitis occurred, C. canimorsus infection should be considered. The purpose of this report is to raise awareness of C. canimorsus among physicians when faced with a patient presenting with meningitis, who has been exposed to dogs or cats. Clinicians should adopt a higher clinical suspicion in the absence of classical risk factors. Although mortality is relatively low, survivors often have neurological sequelae. This case report highlights the importance of thorough history taking to assess risk of underlying C. canimorsus infection, even in immunocompetent hosts.

scholarly journals A rare case of ‘Dog Bite Meningitis’ in a healthy adul

2020 ◽  
Vol 7 (2) ◽  
pp. 22
Author(s):  
Peter Anderyas ◽  
Julia Freckelton ◽  
James J Gome ◽  
Satish Nagarajah ◽  
Nuwan Dhanushka Miththinda Jasenthu Kankanamage
Keyword(s):  
Early Detection ◽  
Antibiotic Therapy ◽  
Rare Case ◽  
Case Reports ◽  
Healthy Woman ◽  
Uneventful Recovery ◽  
Dog Bite ◽  
Capnocytophaga Canimorsus ◽  
Immunocompetent Adult ◽  
Appropriate Therapy

Capnocytophaga canimorsus is a commensal in the normal gingival flora of canine and feline species and is reported to cause infections in humans following bites by these species with potentially serious consequences, especially in the immunocompromised. Here we report a case of a 58-year-old healthy woman presenting with uncomplicated meningitis following a seemingly minor bite by her pet dog. With early detection and appropriate antibiotic therapy she had an uneventful recovery. Our case reports the possibility of this organism infecting an otherwise healthy, immunocompetent adult and the importance of being vigilant of such rare presentations by clinicians which will help to deliver appropriate therapy early to avoid any serious complications.

scholarly journals Granulomatous Hepatitis Following Intra-Vesical Instillation of Bacillus Calmette–Guérin for Treatment of Bladder Cancer

2021 ◽  
Vol 13 (3) ◽  
pp. 611-618
Author(s):  
Elsa Alves Branco ◽  
Raquel Duro ◽  
Teresa Brito ◽  
António Sarmento
Keyword(s):  
Bladder Cancer ◽  
Hepatitis A ◽  
Adverse Reactions ◽  
Superficial Bladder Cancer ◽  
Rare Complication ◽  
Immunocompetent Patient ◽  
Clinical Suspicion ◽  
Bacillus Calmette Guerin ◽  
Granulomatous Hepatitis ◽  
Appropriate Treatment

Intra-vesical instillation of bacillus Calmette–Guérin (BCG) is an important treatment modality of superficial bladder cancer. It is usually well tolerated, although some adverse reactions can occur. One possible yet rare complication is granulomatous hepatitis, that is thought to be caused either by BCG infection or a hypersensitivity reaction to the bacillus. We present a case of a 79-year-old apparently immunocompetent patient who developed granulomatous hepatitis a few months after BCG administration for bladder cancer immunotherapy. It is important to notice that acid-fast smears and cultures are often negative, and these should not exclude diagnosis nor delay treatment. Our case highlights the importance of clinical suspicion and prompt initiation of appropriate treatment.

Rare case of Ureaplasma parvum septic arthritis in an immunocompetent patient

2020 ◽  
Vol 13 (9) ◽  
pp. e236396
Author(s):  
Abuzar Ali Asif ◽  
Moni Roy ◽  
Sharjeel Ahmad
Keyword(s):  
Septic Arthritis ◽  
Rare Case ◽  
Immunocompetent Patient ◽  
Next Generation ◽  
Ureaplasma Parvum ◽  
Urogenital Infections ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Diagnostic Modalities

Mycoplasmatacea family comprises two genera: Mycoplasma and Ureaplasma. Ureaplasma parvum (previously known as U. urealyticum biovar 1) commonly colonises the urogenital tract in humans. Although Ureaplasma species have well-established pathogenicity in urogenital infections, its involvement in septic arthritis has been limited to prosthetic joint infections and immunocompromised individuals. We present a rare case of native right knee infection due to U. parvum identified using next-generation sequencing of microbial cell-free DNA testing and confirmed with PCR assays. This rare case of Ureaplasma septic arthritis was diagnosed using newer next-generation DNA sequencing diagnostic modalities and a literature review of prior cases, antibiotic coverage and antimicrobial resistance is incorporated as part of the discussion.

Aggregatibacter aphrophilus spinal epidural abscess

2020 ◽  
Vol 13 (7) ◽  
pp. e235320
Author(s):  
Antoine Altdorfer ◽  
Pierre Gavage ◽  
Filip Moerman
Keyword(s):  
Risk Factors ◽  
Lower Limb ◽  
Rare Case ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Surgical Drainage ◽  
Eikenella Corrodens ◽  
Aggregatibacter Aphrophilus ◽  
Progressive Neurological Deficit ◽  
Spinal Epidural

A 76-year-old woman with a rare case of spinal epidural abscess (SEA) that had no risk factors for such type of infection, presented symptoms of back pain, progressive neurological deficit of the lower limb and loss of sphincter control. A gadolinium-enhanced MRI confirmed the diagnosis of an SEA. The patient underwent laminectomy with surgical drainage, where cultures showed the presence of Aggregatibacter aphrophilus, a bacterium of the HACEK group (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species), rarely involved in SEA. Following surgery, the patient was treated with intravenous ceftriaxone for 6 weeks, and this gave excellent results.

scholarly journals Cardiac Aspergilloma: A Rare Case of a Cardiac Mass Involving the Native Tricuspid Valve, Right Atrium, and Right Ventricle in an Immunocompromised Patient

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Christina S. Chen-Milhone ◽  
Kalyan Chakravarthy Potu ◽  
Sudhir Mungee
Keyword(s):  
Tricuspid Valve ◽  
Right Atrium ◽  
Rare Case ◽  
Opportunistic Infections ◽  
Immunocompromised Patient ◽  
Clinical Suspicion ◽  
Ventricular Rate ◽  
Immunocompromised Patients ◽  
Transthoracic Echocardiogram ◽  
The Right

Aspergillus can cause devastating opportunistic infections in immunocompromised patients. Rarely does this fungus invade the heart, and when it does, survival is especially poor despite optimal medical and surgical treatment. We report a case of cardiac aspergilloma with involvement of the tricuspid valve and both the right atrium and ventricle found on a transthoracic echocardiogram in an immunocompromised patient after developing atrial fibrillation with rapid ventricular rate. The findings from this case suggest that early clinical suspicion is critical in early diagnosis and thus early treatment.

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