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!