{"pk":5826,"title":"<em>Capnocytophaga ochracea</em> Septicemia After a Dog Bite: The Case of a Usual Suspect Transmitting an Unusual Organism","subtitle":null,"abstract":"<p><strong>Introduction: </strong><em>Capnocytophaga ochracea</em> is found in the human oral microbiome and is a rare cause of antibiotic-resistant, opportunistic septicemia in immunocompromised hosts. The zoonotic transmission of <em>C ochracea</em> from canines to humans has not yet been reported in the literature. Cohabitation with people is associated with oral colonization in dogs and may be a reservoir for <em>Capnocytophaga</em> infections, which have a decreased susceptibility to first-line antibiotics commonly used to treat animal exposures.</p>\n<p><strong>Case Report: </strong>This is the case of a 70-year-old male with a remote history of lymphoma status post splenectomy, in remission, who presented with stigmata of <em>Capnocytophaga</em> septicemia after a dog bite, which included purpura fulminans on physical examination. Initial broad-spectrum coverage with cefepime failed to slow the progression into multiorgan failure. A <em>Capnocytophaga</em> strain with extended resistance was suspected. Antibiotics were transitioned to meropenem, and the patient eventually made a good recovery. Blood cultures isolated <em>C ochracea</em>.</p>\n<p><strong>Conclusion:</strong> <em>Capnocytophaga</em> infections should be suspected in patients with severe sepsis and purpura fulminans after a canine exposure. Canine pets may be a reservoir for <em>Capnocytophaga</em> species with increased antibiotic resistances, such as <em>C ochracea</em>, which trace their origins to the human oral microbiome. A thorough medical history is essential to identify risk factors such as asplenia and active immune compromise that are associated with infections from antibiotic-resistant strains and worse outcomes. For <em>Capnocytophaga</em> infections that fail initial therapies, cephalosporins should be avoided because of high resistance rates, and the use of carbapenems may be favored over combination beta-lactam/beta-lactamase inhibitors in select clinical scenarios.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Keywords: Capnocytophaga"},{"word":"Antibiotic Resistance"},{"word":"dog bite"},{"word":"purpura fulminans"},{"word":"immunocompromise"},{"word":"Capnocytophaga"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0kn6x2s8","frozenauthors":[{"first_name":"Clifford","middle_name":"","last_name":"Chang","name_suffix":"","institution":"Inspira Health Network, Department of Emergency Medicine, Vineland, New Jersey","department":""},{"first_name":"Vakula","middle_name":"","last_name":"Atthota","name_suffix":"","institution":"Inspira Health Network, Department of Infectious Diseases, Vineland, New Jersey; Inspira Health Network, Department of Internal Medicine, Vineland, New Jersey","department":""},{"first_name":"Madison","middle_name":"","last_name":"Lord","name_suffix":"","institution":"Inspira Health Network, Department of Internal Medicine, Vineland, New Jersey","department":""},{"first_name":"Michael","middle_name":"P.","last_name":"Bonk","name_suffix":"","institution":"Rowan University, Cooper Medical School, Division of Critical Care Medicine, Camden, New Jersey","department":""},{"first_name":"Muhammad","middle_name":"","last_name":"Durrani","name_suffix":"","institution":"Inspira Health Network, Department of Emergency Medicine, Vineland, New Jersey","department":""}],"date_submitted":"2023-11-27T08:40:22.380000+08:00","date_accepted":"2024-01-12T07:42:09.517000+08:00","date_published":"2024-07-11T21:00:00+08:00","render_galley":{"label":"Final Article","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/5826/galley/15675/download/"},"galleys":[{"label":"Layout","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/5826/galley/9627/download/"},{"label":"Final Article","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/5826/galley/15675/download/"}]}