Notice to animal lovers. Capnocytophaga canimorsus, a commensal germ in the oral cavity of dogs and cats, is sometimes responsible for very serious human infections when biting or licking. The mortality rate is estimated between 30% and 60% in the event of the occurrence of septic shock.
In France, animal bite wounds are common. In 2008, 316,200 patients consulted the emergency room for this reason, a rate of 103.9 per 104 inhabitants. About 20% of dog bite wounds, and at least 50% of cat bite wounds that have not been adequately treated become infected.
Although most injuries are benign, they are still the cause of an in-hospital mortality of 0.5%. Indeed, “Capnocytophaga canimorsus, a commensal germ from the oral cavity of dogs and cats, is sometimes responsible for very serious human infections during biting or licking”, indicates a study published last April in the Journal of Internal Medicine. The mortality rate is estimated between 30% and 60% in the event of the occurrence of septic shock, when the patient is not treated in time.
Populations at risk of infection via Capnocytophaga canimorsus
Populations particularly at risk of infection via Capnocytophaga canimorsus are diabetics, patients with vascular insufficiency, immunocompromised patients (by disease or by immunosuppressive treatment, or following splenectomy), and patients with hepatic disorders due to to alcoholism. Some experts also consider age over 50 and female gender as risk factors.
While a bite wound may not look alarming, any infection occurring within 48 to 72 hours requires urgent medical attention. The first case of contamination of Capnocytophaga canimorsus to man is reported in 1979. Capnocytophaga canimorsu is also the cause of three deaths in France between February 2017 and April 2018, explain the scientists in their study published in June in the journal paper Medicine and infectious diseasess.
The case of American Greg Manteufel, whose arms and legs have been amputated
More recently, theAmerican Greg Manteufel started with a fever and vomiting. So far, his symptoms have not worried him that much. But the next day, his condition suddenly worsened. While his fever had increased, Greg Manteufel was also the victim of fits of delirium andhallucinations. His wife Dawn Manteufel immediately transported him to the nearest hospital.
The shocking reason that this man’s legs and hands were amputated: A dog’s saliva https://t.co/SSz9LBghaG
—Washington Post (@washingtonpost) August 1, 2018
Clots in the veins
On the spot, the doctors discovered that his body was covered with bruises. Marks that were not there when the couple had left their home a few minutes earlier. Despite antibiotic treatment, his condition worsened. Clots have formed in his veins and are preventing the blood flow from supplying the extremities of his body. His tissues are slowly dying. In just a few days, Greg Manteufel had his arms and legs amputated so that the infection did not spread to vital organs.
Last April, doctors reported in the journal Science Direct “the observation of a 54-year-old patient, with no history, living near a dog, who presented with fatal septic shock with purpura fulminans related to a C. canimorsus infection, without any obvious notion of bite or ‘ wound licking”. This case recalls “the potential extreme seriousness of rare C. canimorsus sepsis and illustrates the fact that this is possible without a context of immunosuppression and without the notion of inoculation”, they wrote.
In February, The Lancet also related the case of a 47-year-old Frenchman who, bitten by his dog, had suffered similar symptoms. While the antibiotic treatment prescribed by his doctor did not reduce his fever and he was the victim of several illnesses, the patient was hospitalized at the Intercommunal Hospital Center of Fréjus – Saint-Raphaël. Doctors then diagnose the same finger tissue infection as Greg Manteufel. The patient died 48 hours after his hospitalization.
Symptoms of infection via Capnocytophaga canimorsus
Hosted in the gingival flora of many dogs and cats, even healthy ones, the Capnocytophaga canimorsus bacterium can temporarily be transmitted to humans by biting, licking or simply by being close to animals. According to The world, “a C. canimorsus infection is associated with a dog bite in 60% of cases, with licking on a pre-existing skin lesion in about 30% of cases”.
Symptoms appear one to eight days after exposure to the bacteria but are usually present by the second day. Patients often complain of a variable combination of manifestations including fever, vomiting, diarrhoea, malaise, abdominal pain, myalgia, confusion or migraine. More severe cases have been published reporting endocarditis, disseminated intravascular coagulation and meningitis.
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