Secretory diarrhea following a dog bite

Area of Science:

• Infectious Diseases
• Microbiology
• Critical Care Medicine

Background:

• Overwhelming sepsis is a life-threatening condition.
• Secretory diarrhea is an uncommon complication of sepsis.
• Dog bites can transmit various pathogens.

Observation:

• A previously healthy individual developed fulminant sepsis following a dog bite.
• The patient presented with severe secretory diarrhea, dermatologic manifestations, and disseminated intravascular coagulation (DIC).
• Standard cultures did not identify Capnocytophaga canimorsus, a bacterium previously associated with similar presentations.

Findings:

• This case describes a unique presentation of overwhelming sepsis with severe secretory diarrhea, distinct from previously reported cases.
• The absence of cultured Capnocytophaga canimorsus suggests alternative or unidentified causative agents.
• The clinical triad of septic shock, skin lesions, and DIC post-dog bite warrants consideration of novel pathogens.

Implications:

• This case highlights the potential for Capnocytophaga canimorsus or related organisms to cause severe secretory diarrhea in sepsis.
• It expands the differential diagnosis for overwhelming sepsis with gastrointestinal and dermatologic complications.
• Further research is needed to identify the specific pathogen responsible for this severe sepsis syndrome.