Capnocytophaga canimorsus 败血症伴有败血症引起的凝血功能障碍和心内膜炎。

IF 1 Q4 INFECTIOUS DISEASES
Case Reports in Infectious Diseases Pub Date : 2024-09-18 eCollection Date: 2024-01-01 DOI:10.1155/2024/4010115
Jeannine L Kühnle, Maximilian Leitner, Vitalie Mazuru, Kai Borchardt, Sören L Becker, Franziska Roth, Robert Bals, Philipp M Lepper, Hans-Joachim Schäfers, Isabella T Jaumann
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引用次数: 0

摘要

Capnocytophaga canimorsus 是一种罕见的严重感染病菌,死亡率高达 10%至 30%。它通常出现在猫和狗的口腔中,可导致免疫力低下的患者出现严重败血症。一名 81 岁的白种女性患者在被狗咬伤手指后出现卡尼莫氏菌败血症,三天后才到我们急诊科就诊。她最初因败血症、血栓性血小板减少症和血吸虫实验室检查结果而就诊,这提示了血栓性微血管病多种亚型的鉴别诊断。由于脓毒性休克伴有循环功能不全,她被送入萨尔州大学医院内科重症监护室。患者接受了血浆置换术、抗生素和透析治疗,病情明显好转。患指的指尖出现坏死,不得不截肢。此外,患者还被诊断出患有二尖瓣心内膜炎,这是一种非常罕见的卡尼莫氏菌感染并发症。患者接受了抗生素保守治疗,在确诊 8 周后已无法检测到该并发症。无需进行手术治疗。该病例充分说明,血栓性血小板减少性紫癜(TTP)、弥散性血管内凝血(DIC)和败血症诱发的凝血病(SIC)之间仍然很难区分,尤其是在急性疾病的早期阶段,特别是在卡尼莫氏菌诱发的败血症中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Capnocytophaga canimorsus Septicemia With Sepsis-Induced Coagulopathy and Endocarditis.

Capnocytophaga canimorsus is a rare cause of serious infections with a high mortality of 10% to 30%. It is usually found in the oral cavity of cats and dogs and can cause severe sepsis in immunocompromised patients. An 81-year-old female Caucasian patient presented with C. canimorsus sepsis after a dog bite in her finger three days before presentation to our emergency department. She initially was presented to us with sepsis, thrombopenia, and schistocytes in her laboratory findings, suggesting the differential diagnoses of the multiple subtypes of thrombotic microangiopathy. She was admitted to the medical intensive care unit of the University Hospital of Saarland because of septic shock with circulatory insufficiency. The patient received plasmapheresis, antibiotics, and dialysis, under which she improved significantly. The fingertip of the affected finger developed necrosis and had to be amputated. Furthermore, the patient was diagnosed with a mitral valve endocarditis, a very rare complication of C. canimorsus infection. It was treated conservatively with antibiotics and was no longer detectable 8 weeks after the diagnosis. Surgical intervention was not needed. The case describes well that it is still difficult to distinguish between thrombotic thrombocytopenic purpura (TTP), disseminated intravascular coagulation (DIC), and sepsis-induced coagulopathy (SIC), especially in the early phases of acute disease, especially in C. canimorsus-induced sepsis.

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