Capnocytophaga canimorsus.
The Doctors
My mom had been bitten by a dog last week. She started having flu like
symptoms by the 4th day. She was hospitalized the 6th day and now it
has been 8 days since the bite and she has DF-2 (Capnocytophaga
canimorsus)!! She is going to die is what the doctors tell us. She is
turning a dark purple from bleeding under her skin all over. Her bite
location near her fingers and the remaining fingers on that hand are now
black and will possibly need to be amputated. Her right leg is white
and yellow with the bottom of her foot being black, they let us know she
is having that amputated, and so far her left also from knee down. Her
platelet count is under 10!!!!! She is slowly bleeding to death and her
body is shutting down. Her kidneys need dialysis now.
I have been on the net looking, because her doctors are quite new to
this also. I found a med that they were not even using that now they
are after reading the info I found. Is there any other experimental?
How can one survive an operation with such a low platelet count and
troubles? If this helps others with a dog bite: all dogs carry this
disease and anyone can get it from a bite or lick, but those who abuse
alcohol, are asplenic, or on cortizoid treatments are most susceptible.
Symptoms occur 1-30 days after but the average is 5.5 days/ It is FATAL
if not promptly attended. I know all this, but our family needs info on
new treatments or possible other cases known that we may learn from or
contact that doctor.
ANSWER by a specialist in infectious disease
The case sounds classic for that organism, and, though uncommon, is well
described in the literature and every ID Fellow studies DF2 sepsis for
the
"boards".
The organism is a normal one in the oral flora of canines ( just like
Pasteurella). It actually not particularly resistant to antibiotics (
you
will see in the Sanford handbook all the residents carry it is treated
with
Augmentin, Unasyn, Clindamycin).
The real issue is that it causes DIC and a catastrophic infection in the
splenectomized patient; that is, the organism triggers off multiple
cascades
of host defenses which themselves are the difficult to treat part of
the
infection. The splenectomized patient is at risk for similar illness
from
encapsulated organisms like pneumococcus, and the protozoan Babesia.
We recently had a case at LVH of nearly fatal catastrophic illness form
Vibrio vulnificus from shellfish due not so much from a powerful
organism,
but the splenectomized state of the patient.
The best hope for future survival against DF2 is a vaccine or better
tools for critical care doctors to manage septic shock and DIC.
DISCLAIMER: The material contained here should not be considered a
substitute for a physician. These are only general guidelines to help
you think about the medical possibilities. You are encouraged to consult
your own health care provider with any questions or concerns you may
have regarding your condition. Ask the Doctors website is at
http://www.flora.org/ask-doctor/.
Your feedback is always welcome.