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犬咬二氧化碳嗜纤维菌(原DF-2)败血症所致暴发性紫癜和对称性外周坏疽——犬咬伤的一种并发症

Purpura fulminans and symmetrical peripheral gangrene caused by Capnocytophaga canimorsus (formerly DF-2) septicemia--a complication of dog bite.

作者信息

Kullberg B J, Westendorp R G, van 't Wout J W, Meinders A E

机构信息

Department of Infectious Diseases, University Hospital, Leiden, The Netherlands.

出版信息

Medicine (Baltimore). 1991 Sep;70(5):287-92. doi: 10.1097/00005792-199109000-00001.

Abstract

We review the syndrome of Capnocytophaga canimorsus (DF-2) septicemia after exposure to dogs or cats. We describe a previously healthy patient who developed diffuse intravascular coagulation and symmetrical peripheral gangrene as a result of C. canimorsus septicemia after a dog bite. To our knowledge, this patient was the first to receive combined plasmapheresis and leukapheresis for C. canimorsus septicemia. Symmetrical peripheral gangrene is frequently associated with C. canimorsus septicemia and may lead to an early diagnosis in patients who become severely ill after a dog bite. Other complications include arthritis, meningitis, and endocarditis. These manifestations can also be found in previously healthy patients, although a prior splenectomy or other causes of impaired host defense clearly enhance the risk. Prompt treatment with penicillin G is required.

摘要

我们回顾了接触狗或猫后发生的犬咬二氧化碳嗜纤维菌(DF-2)败血症综合征。我们描述了一名既往健康的患者,其在被狗咬伤后因犬咬二氧化碳嗜纤维菌败血症而发生弥漫性血管内凝血和对称性外周坏疽。据我们所知,该患者是首例接受血浆置换和白细胞去除术联合治疗犬咬二氧化碳嗜纤维菌败血症的患者。对称性外周坏疽常与犬咬二氧化碳嗜纤维菌败血症相关,可能有助于对狗咬伤后病情严重的患者进行早期诊断。其他并发症包括关节炎、脑膜炎和心内膜炎。这些表现也可见于既往健康的患者,尽管先前的脾切除术或其他宿主防御功能受损的原因显然会增加风险。需要用青霉素G进行及时治疗。

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