A 52-year-old man with malaise and a petechial rash

The Journal of Emergency Medicine
Roger A BandJeanmarie Perrone

Abstract

Capnocytophaga canimorsus is a Gram-negative, fusiform, rod-shaped organism that is part of the normal oral flora of dogs, cats, and other animals. A significant number of Emergency Department (ED) patients are surgically or functionally asplenic and may be at marked risk for overwhelming post-splenectomy infection (OPSI). OPSI has a mortality rate estimated to be up to 70%. The risk of sepsis is estimated to be 30-60 times greater after splenectomy, and C. canimorsus is one of the organisms that can cause catastrophic OPSI. To describe a case of C. canimorsus septic shock in a post-splenectomy patient and review the epidemiology of OPSI, the role of the spleen in protecting the body from infection, and the potential role of early goal-directed therapy in the resuscitation of patients with OPSI. A 52 year-old man with a past medical history significant for idiopathic thrombocytopenic purpura (status post-splenectomy), and non-Hodgkin lymphoma (treated for cure), was brought to the ED with the chief complaints of light-headedness, malaise, and a rapidly spreading rash. He was found to be hypotensive, tachycardic, and tachypneic, and had a marked lactic acidosis. He was aggressively resuscitated with large volume fluid resuscitat...Continue Reading

References

May 13, 1999·Critical Care Medicine·M L Brigden, A L Pattullo
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Jun 20, 2006·Annals of Emergency Medicine·H Bryant NguyenUNKNOWN Emergency Department Sepsis Education Program and Strategies to Improve Survival (ED-SEPSIS) Working Group

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Citations

Apr 14, 2012·Scandinavian Journal of Infectious Diseases·Claus Behrend ChristiansenKirsten Møller
Apr 2, 2015·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·T Butler
Jun 27, 2009·The Lancet Infectious Diseases·Richard L OehlerSandra Gompf
Dec 3, 2016·Der Internist·I El-BattrawyI Akin
Apr 30, 2021·Journal of Global Infectious Diseases·Kensuke NakamuraHideki Hashimoto

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