Infective endocarditis caused by Capnocytophaga canimorsus; a case report. 2019

Jun Sakai, and Kazuhito Imanaka, and Masahiro Kodana, and Kana Ohgane, and Susumu Sekine, and Kei Yamamoto, and Yusuke Nishida, and Toru Kawamura, and Takahiro Matsuoka, and Shigefumi Maesaki, and Hideaki Oka, and Hideaki Ohno
Department of Infectious Disease and Infection Control, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.

BACKGROUND Capnocytophaga canimorsus is a gram-negative bacterium and an oral commensal in dogs and cats, but occasionally causes serious infections in humans. Septicemia is one of the most fulminant forms, but diagnosis of C. canimorsus infection is often difficult mainly because of its very slow growth. C. canimorsus infective endocarditis (IE) is rare and is poorly understood. Since quite a few strains produce β-lactamase, antimicrobial susceptibility is pivotal information for adequate treatment. We herein report a case with C. canimorsus IE and the results of drug susceptibility test. METHODS A 46-year-old man had a dog bite in his left hand 3 months previously. The patient was referred to our hospital for fever (body temperature > 38 °C), visual disturbance, and dyspnea. Echocardiography showed aortic valve regurgitation and vegetation on the leaflets. IE was diagnosed, and we initially administered cefazolin and gentamycin assuming frequently encountered microorganisms and the patient underwent aortic valve replacement. C. canimorsus was detected in the aortic valve lesion and blood cultures. It was also identified by 16S ribosome DNA sequencing. Ceftriaxone were started and continued because disk diffusion test revealed the isolate was negative for β-lactamase and this case had cerebral symptoms. The patient successfully completed antibiotic treatment following surgery. CONCLUSIONS We diagnosed C. canimorsus sepsis and IE by extended-period blood cultures and 16S ribosome DNA sequencing by polymerase chain reaction, and successfully identified its drug susceptibility.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001733 Bites and Stings Injuries inflicted by the TEETH or poisoning caused by VENOMS of animals. Stings,Bites,Stings and Bites,Bite,Sting
D002206 Capnocytophaga A gram-negative gliding bacterium isolated from the oral cavity. It is a pathogen often causing PERIODONTITIS.
D002437 Cefazolin A semisynthetic cephalosporin analog with broad-spectrum antibiotic action due to inhibition of bacterial cell wall synthesis. It attains high serum levels and is excreted quickly via the urine. Cephazolin,Ancef,Cefamedin,Cefamezine,Cefazolin Sodium,Cephamezine,Cephazolin Sodium,Gramaxin,Kefzol,Sodium Cephazolin,Totacef,Cephazolin, Sodium,Sodium, Cefazolin,Sodium, Cephazolin
D002443 Ceftriaxone A broad-spectrum cephalosporin antibiotic and cefotaxime derivative with a very long half-life and high penetrability to meninges, eyes and inner ears. Benaxona,Cefatriaxone,Cefaxona,Ceftrex,Ceftriaxon,Ceftriaxon Curamed,Ceftriaxon Hexal,Ceftriaxona Andreu,Ceftriaxona LDP Torlan,Ceftriaxone Irex,Ceftriaxone Sodium,Ceftriaxone Sodium, Anhydrous,Ceftriaxone, Disodium Salt,Ceftriaxone, Disodium Salt, Hemiheptahydrate,Lendacin,Longacef,Longaceph,Ro 13-9904,Ro-13-9904,Ro13-9904,Rocefalin,Rocefin,Rocephin,Rocephine,Tacex,Terbac,Anhydrous Ceftriaxone Sodium,Ro 13 9904,Ro 139904,Ro13 9904,Ro139904
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D004697 Endocarditis, Bacterial Inflammation of the ENDOCARDIUM caused by BACTERIA that entered the bloodstream. The strains of bacteria vary with predisposing factors, such as CONGENITAL HEART DEFECTS; HEART VALVE DISEASES; HEART VALVE PROSTHESIS IMPLANTATION; or intravenous drug use. Bacterial Endocarditides,Bacterial Endocarditis,Endocarditides, Bacterial
D005839 Gentamicins A complex of closely related aminoglycosides obtained from MICROMONOSPORA purpurea and related species. They are broad-spectrum antibiotics, but may cause ear and kidney damage. They act to inhibit PROTEIN BIOSYNTHESIS. Gentamicin Sulfate (USP),Gentamycin,G-Myticin,Garamycin,Gentacycol,Gentamicin,Gentamicin Sulfate,Gentamycins,Gentavet,Genticin,G Myticin,GMyticin,Sulfate, Gentamicin
D006350 Heart Valve Prosthesis A device that substitutes for a heart valve. It may be composed of biological material (BIOPROSTHESIS) and/or synthetic material. Prosthesis, Heart Valve,Cardiac Valve Prosthesis,Cardiac Valve Prostheses,Heart Valve Prostheses,Prostheses, Cardiac Valve,Prostheses, Heart Valve,Prosthesis, Cardiac Valve,Valve Prostheses, Cardiac,Valve Prostheses, Heart,Valve Prosthesis, Cardiac,Valve Prosthesis, Heart

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