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犬咬二氧化碳嗜纤维菌在髂动脉感染性动脉瘤中的作用:分子诊断的作用

Capnocytophaga canimorsus in Iliac Artery Mycotic Aneurysm: The Role of Molecular Diagnostics.

作者信息

Scholin Celine, Calvin Andrew D, Shweta F N U, Tallarita Tiziano

机构信息

Doctor of Medicine Program, Medical College of Wisconsin - Central Wisconsin, Marshfield, WI, USA.

Department of Cardiovascular Medicine, Mayo Clinic Health System, Eau Claire, WI, USA.

出版信息

Am J Case Rep. 2025 Jan 14;26:e946054. doi: 10.12659/AJCR.946054.

Abstract

BACKGROUND The bacterial organism Capnocytophaga canimorsus is an oral commensal of cats and dogs and can cause life-threatening infections like mycotic aneurysm, meningitis, and sepsis. Mycotic aneurysms occur when microbial infections cause arterial wall degeneration. Difficulty in diagnosing Capnocytophaga canimorsus infection can occur due to the bacteria's fastidious nature and laboratory testing limitations, contributing to the infection's high morbidity and mortality. This report describes the case of a patient with an iliac artery mycotic aneurysm 2 months after a dog bite. Identification of Capnocytophaga canimorsus was achieved through polymerase chain reaction. CASE REPORT The 67-year-old female patient presented initially with nonspecific abdominal pain. Imaging revealed a right iliac artery abnormality suspicious for mycotic aneurysm. Capnocytophaga canimorsus was identified through broad-range bacterial polymerase chain reaction after standard culture failed to determine the infectious etiology. A history of dog bite was discovered after diagnosis. When standard culture cannot provide a diagnosis, 16s rRNA polymerase chain reaction is the preferred molecular-based test at our institution. CONCLUSIONS Through presentation of a case of Capnocytophaga canimorsus mycotic aneurysm in an immunocompetent woman, this report illustrates the importance of familiarity with Capnocytophaga canimorsus and molecular laboratory methods in achieving favorable outcomes when faced with Capnocytophaga canimorsus infection. In these difficult cases, 16s rRNA polymerase chain reaction and similar molecular technologies are becoming essential. This case also highlights thorough history-taking as essential for guiding correct diagnosis and reinforces that infection with Capnocytophaga canimorsus should be investigated when there is a history of dog bite.

摘要

背景

犬咬二氧化碳嗜纤维菌是猫和狗口腔中的共生菌,可引起危及生命的感染,如霉菌性动脉瘤、脑膜炎和败血症。当微生物感染导致动脉壁变性时,就会发生霉菌性动脉瘤。由于该细菌苛求的特性和实验室检测的局限性,犬咬二氧化碳嗜纤维菌感染的诊断可能会遇到困难,这导致了该感染的高发病率和死亡率。本报告描述了一名患者在被狗咬伤2个月后发生髂动脉霉菌性动脉瘤的病例。通过聚合酶链反应鉴定出犬咬二氧化碳嗜纤维菌。病例报告:这位67岁的女性患者最初表现为非特异性腹痛。影像学检查显示右髂动脉异常,怀疑为霉菌性动脉瘤。在标准培养未能确定感染病因后,通过广泛的细菌聚合酶链反应鉴定出犬咬二氧化碳嗜纤维菌。诊断后发现有被狗咬伤的病史。当标准培养无法提供诊断时,16s rRNA聚合酶链反应是我们机构首选的基于分子的检测方法。结论:通过介绍一例免疫功能正常女性的犬咬二氧化碳嗜纤维菌霉菌性动脉瘤病例,本报告说明了熟悉犬咬二氧化碳嗜纤维菌和分子实验室方法在面对犬咬二氧化碳嗜纤维菌感染时取得良好结果的重要性。在这些困难病例中,16s rRNA聚合酶链反应和类似的分子技术正变得至关重要。本病例还强调了全面的病史采集对于指导正确诊断的必要性,并强化了当有被狗咬伤的病史时,应调查是否感染犬咬二氧化碳嗜纤维菌。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/045d/11742453/5894549c5475/amjcaserep-26-e946054-g001.jpg

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