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Induction of Graft-versus-host Disease and In Vivo T Cell Monitoring Using an MHC-matched Murine Model
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Purpura Fulminans from Capnocytophaga canimorsus in an Immunocompromised Host

Indumathy Varadarajan1, Natalie Pham2, Karen Ballen1

  • 1Department of Hematology Oncology, University of Virginia Medical Center, Charlottesville, VA, USA.

Case Reports in Oncology
|October 30, 2024
PubMed
Abstract

Insights

Purpura fulminans, a severe Capnocytophaga canimorsus infection, can be fatal in immunocompromised patients, particularly after stem cell transplants. Early recognition and antibiotics are crucial to reduce mortality and limb amputations.

Area of Science:

  • Infectious Diseases
  • Hematology
  • Transplantation Immunology

Background:

  • Purpura fulminans is a rare, severe complication of Capnocytophaga canimorsus bacteremia.
  • Immunocompromised hosts, especially allogeneic hematopoietic stem cell transplant (HSCT) recipients, are at high risk.
  • This condition has a high mortality rate (up to 60%) and often necessitates multiple extremity amputations.

Observation:

  • A 31-year-old woman, post-myeloablative allogeneic HSCT and on immunosuppressive therapy (rituximab, tacrolimus), developed purpura fulminans and septic shock.
  • Despite aggressive antibiotic and supportive care, septic shock was managed, but bilateral below-knee amputations were required.

Findings:

  • Capnocytophaga canimorsus bacteremia can lead to purpura fulminans and septic shock in HSCT recipients.
  • Aggressive treatment, including antibiotics and supportive care, is essential but may not prevent severe complications like amputation.
  • Early diagnosis and prompt antibiotic initiation are critical for improving outcomes.

Implications:

  • Highlights the severe risks of zoonotic infections like C. canimorsus in immunocompromised patients.
  • Emphasizes the need for pre-transplant counseling regarding pet ownership and infection prevention.
  • Underscores the importance of vigilant monitoring and rapid intervention in HSCT recipients presenting with sepsis.
Keywords:
Capnocytophaga canimorsusChronic graft-versus-host diseasePurpura fulminansStem cell transplant

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