Nishioka Hiroaki, Kozuki Tomohiro, Kamei Hiroki
Department of General Internal Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minami-machi, Minatojima, Chuo-ku, Kobe, Hyogo 650-0047, Japan.
Department of General Internal Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minami-machi, Minatojima, Chuo-ku, Kobe, Hyogo 650-0047, Japan.
J Infect Chemother. 2015 Mar;21(3):215-7. doi: 10.1016/j.jiac.2014.09.001. Epub 2014 Oct 23.
Capnocytophaga canimorsus is part of normal gingival flora of dogs and cats. The organism can cause septicemia, meningitis, and endocarditis in humans after contact with dogs or cats. In spite of the frequency of gastrointestinal symptoms in C. canimorsus infection patients, specific gastrointestinal disease or clinical images have not been reported. We report a case of C. canimorsus bacteremia presenting with acute cholecystitis in elderly woman. She suffered from general fatigue and right upper abdominal pain. She had leukocytosis and abnormal liver function tests. She showed abnormal findings of the gallbladder by abdominal computed tomography and ultrasonography. She was diagnosed with acute cholecystitis without gallstones and was administered with antibiotics. C. canimorsus was isolated from blood cultures. A history of an insignificant wound secondary to a dog bite was elicited. She recovered completely with antibiotic treatment. This case revealed that C. canimorsus bacteremia can be presented with acute cholecystitis, suggesting that C. canimorsus could cause cholecystitis. And this cholecystitis can be treated with antibiotics without operation. Physicians seeing patients with acute cholecysitis should ask questions regarding animal contact.
犬咬二氧化碳嗜纤维菌是犬猫正常牙龈菌群的一部分。该菌在人类接触犬猫后可导致败血症、脑膜炎和心内膜炎。尽管犬咬二氧化碳嗜纤维菌感染患者胃肠道症状常见,但尚未见特定胃肠道疾病或临床影像报道。我们报告一例老年女性犬咬二氧化碳嗜纤维菌血症伴急性胆囊炎的病例。她感到全身乏力和右上腹疼痛。她有白细胞增多和肝功能检查异常。腹部计算机断层扫描和超声检查显示胆囊有异常表现。她被诊断为无胆结石的急性胆囊炎,并接受了抗生素治疗。从血培养中分离出犬咬二氧化碳嗜纤维菌。追问得知她有因犬咬伤导致的轻微伤口史。经抗生素治疗后她完全康复。该病例显示犬咬二氧化碳嗜纤维菌血症可表现为急性胆囊炎,提示犬咬二氧化碳嗜纤维菌可引起胆囊炎。而且这种胆囊炎无需手术用抗生素即可治疗。诊治急性胆囊炎患者的医生应询问动物接触史。