Gary A, Bravard P, Frebourg N, Collange O, Nouveau J, Carré D, Veber B, Moirot E, Joly P
(1) Clinique Dermatologique, CHU de Rouen.
Ann Dermatol Venereol. 2006 Jan;133(1):27-9. doi: 10.1016/s0151-9638(06)70838-9.
Capnocytophaga canimorsus is a Gram negative bacillus present in oral flora and in saliva of dogs and cats. It can be responsible for septicaemia and meningitides in some patients after dog or cat bite two patient with a septic shock due to C. canimorsus, who presented with an extensive pupura are reported.
A 50 year-old man with a past history of splenectomy was referred to an emergency department for a shock with vomiting, abdominal pain and generalized ecchymotic purpura culture samples isolated C. canimorsus in peritoneal fluid. Purpura occurred secondary to a disseminated intravascular coagulation. Despite intensive care and major antibiotherapy, the patient rapidly died. Four days previously, the patient administered pills in his dog mouth. The second patient was a 39 year old alcoholic man who was hospitalised for vomiting and septic shock witch occurred 24 hours after a dog bite. He presented with a livido and a diffuse purpura associated with necrotic lesions. Cultures of blood samples isolated C. canimorsus.
These severe infections due to C. canimorsus should be avoided by the routine use of early antibiotherapy with amoxicilline and clavulanic acid in patients with dog or cat bite, particularly if patient with associated debilitating disorders.
犬咬二氧化碳嗜纤维菌是一种革兰氏阴性杆菌,存在于狗和猫的口腔菌群及唾液中。在某些被狗或猫咬伤的患者中,它可导致败血症和脑膜炎。本文报告了两名因犬咬二氧化碳嗜纤维菌感染而出现感染性休克并伴有广泛紫癜的患者。
一名有脾切除病史的50岁男性因休克、呕吐、腹痛和全身瘀斑性紫癜被转诊至急诊科。腹膜液培养样本分离出犬咬二氧化碳嗜纤维菌。紫癜是由弥散性血管内凝血继发引起的。尽管进行了重症监护和大剂量抗生素治疗,患者仍很快死亡。四天前,该患者曾将药丸放入其狗口中。第二名患者是一名39岁的酗酒男性,因狗咬伤24小时后出现呕吐和感染性休克而住院。他表现为青斑和伴有坏死性病变的弥漫性紫癜。血液样本培养分离出犬咬二氧化碳嗜纤维菌。
对于被狗或猫咬伤的患者,尤其是伴有虚弱性疾病的患者,应常规早期使用阿莫西林和克拉维酸进行抗生素治疗,以避免这些由犬咬二氧化碳嗜纤维菌引起的严重感染。