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Renal abscess with Capnocytophaga canimorsus infection from a dog bite
Santiago Trainor-Moss1, Rebecca Ruth Acquah2, Mary Peirse3
1University of Aberdeen Medical School, Aberdeen, UK.
Abstract:
We present a case of renal abscess caused by Capnocytophaga canimorsus infection in a previously healthy middle-aged man. He presented with sepsis and an acute kidney injury, and although not identified on his initial assessment, he had sustained a dog bite 5 days prior to hospital admission. The patient developed left loin pain and imaging investigation revealed a renal abscess. Gram stain showed a gram-negative bacillus and C. canimorsus was identified by 16S PCR from these samples along with aspirate from the abscess. The patient responded to treatment with carbapenems but required a prolonged course. His clinical condition was further complicated by a pleural effusion and the development of fatigue symptoms consistent with a post-infection chronic fatigue syndrome. We present this case which we believe to be the first documented case of C. canimorsus causing renal abscess. We discuss the challenges relating to investigation, management and the importance of detailed diagnostic exposure histories in sepsis of unknown origin.
Insights
Capnocytophaga canimorsus, a bacterium typically from dog bites, can cause severe renal abscesses and sepsis. Early diagnosis and prolonged antibiotic treatment are crucial for recovery.
Area of Science:
- Infectious Diseases
- Nephrology
- Microbiology
Background:
- Capnocytophaga canimorsus is an opportunistic pathogen, primarily associated with dog or cat bites.
- Renal abscesses are serious infections that can lead to sepsis and acute kidney injury.
Observation:
- A previously healthy middle-aged man presented with sepsis and acute kidney injury following an unrecognized dog bite.
- Imaging revealed a renal abscess, and Capnocytophaga canimorsus was identified via 16S PCR from clinical samples.
Findings:
- This case represents the first documented instance of Capnocytophaga canimorsus causing a renal abscess.
- The patient required a prolonged course of carbapenem treatment and developed a pleural effusion and post-infectious fatigue syndrome.
Implications:
- Highlights the importance of detailed exposure histories in diagnosing sepsis of unknown origin.
- Emphasizes the need for considering Capnocytophaga canimorsus in patients with sepsis and renal involvement, especially after animal contact.
- Underscores the challenges in managing Capnocytophaga canimorsus infections and the potential for long-term sequelae.
