7/25 Morning Report w/ Eric Bautista and DD: Sepsis in an asplenic patient

A middle aged man w/ history of splenectomy presents with sepsis, multiorgan failure, and DIC following a dog bite, ultimately dx with capnocytophaga canimorus.
*1) As we learned in med school, asplenic patients are prone to infection with encapsulated organisms, ie Neiserria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae. However, they are ALSO prone to some gram negative infections including bordetella and capnocytophaga as in our patient!! Use broad spectrum abx (Vancomycin + meningeal dosing of ceftriaxone or cefotaxime). 2) Recognize Capnocytophaga as a rare cause of severe sepsis, DIC, and purpura fulminans*
Purpura Fulminans (see image below): Describes acute, widespread, angulated/retiform purpura often seen in the setting of DIC. The etiology includes essentially anything that can make someone very sick, but infections particularly known to cause this include both Neisseria meningitidis AND Capnocytophaga. Thanks to Dr. Coppolino for bringing this up!
Inline image 1

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s