Deshmukh Pravin M, Camp Carol J, Rose Frederick B, Narayanan Surya
Department of Infectious Diseases, Albany Medical College, Albany, New York, USA.
Am J Med Sci. 2004 Jun;327(6):369-72. doi: 10.1097/00000441-200406000-00015.
The authors describe a fatal case of purpura fulminans with symmetrical peripheral gangrene and sepsis caused by Capnocytophaga canimorsus in a 45-year-old, previously healthy woman who was bitten by a dog at an animal shelter where she was employed. Absent in this patient were the usual risk factors, including immunosuppression, alcohol abuse, corticosteroid therapy, and splenectomy. The patient's presentation to the emergency room late in the course of the infection probably effected her death. C canimorsus should be strongly suspected in any case of septicemia following a dog bite. Prompt therapy may influence the potentially fatal course of systemic infection. Employees and/or volunteers who work in animal shelters should be cognizant of the potential risks of a dog or cat bite and follow recommended procedures when such an incident occurs.
作者描述了一例暴发性紫癜致死病例,该病例伴有对称性外周坏疽和败血症,由犬咬二氧化碳嗜纤维菌引起,患者为一名45岁的既往健康女性,她在受雇的动物收容所被狗咬伤。该患者不存在常见的危险因素,包括免疫抑制、酗酒、皮质类固醇治疗和脾切除术。患者在感染后期才到急诊室就诊,这可能导致了她的死亡。对于任何狗咬伤后发生败血症的病例,都应高度怀疑犬咬二氧化碳嗜纤维菌感染。及时治疗可能会影响全身性感染的潜在致命病程。在动物收容所工作的员工和/或志愿者应认识到被狗或猫咬伤的潜在风险,并在发生此类事件时遵循推荐的程序。