First reported case of lead-related infective endocarditis secondary to Capnocytophaga canimorsus: 'Dog Scratch'...

Area of Science:

• Infectious Diseases
• Cardiology
• Bacteriology

Background:

• A 76-year-old woman with dilated cardiomyopathy and a cardiac resynchronization device developed a 6-week history of malaise, night sweats, and fever.
• The patient experienced multiple hospital admissions with varied diagnoses and received several courses of antibiotics with only temporary symptom relief.

Observation:

• Blood cultures identified Gram-negative rods, prompting further analysis at a specialist center.
• Echocardiography revealed thickening of the distal right ventricular lead, with transesophageal imaging confirming a vegetation on the lead.
• The patient recalled being scratched by her dog two weeks prior to symptom onset.

Findings:

• The causative agent was identified as Capnocytophaga canimorsus, a bacterium commonly found in dogs and cats.
• The infection led to a vegetation on the patient's cardiac resynchronization device lead.

Implications:

• This case highlights the potential for Capnocytophaga canimorsus transmission from animal scratches to cause severe infections, including device-related endocarditis.
• Early recognition of the zoonotic source and appropriate antibiotic therapy, alongside device management, are critical for successful patient outcomes.
• Further research into Capnocytophaga canimorsus pathogenesis and diagnostic strategies in immunocompromised or device-dependent patients is warranted.