Capnocytophaga canimorsus bacteremia: clinical features and outcomes from a Helsinki ICU cohort.

BACKGROUND: Capnocytophaga canimorsus is a gram-negative rod capable of causing severe sepsis or septic shock. We studied the characteristics of patients with C. canimorsus bacteremia treated in intensive care unit (ICU).

METHODS: Patients with C. canimorsus bacteremia in the Helsinki University Hospital district from 2005 to 2014 were retrospectively reviewed using laboratory database and electronical patient records.

RESULTS: We identified 65 patients with C.canimorsus bacteremia. Of these, 16 (25%) were treated in an ICU. The most commonly affected organ systems were coagulation (94%) and kidney (69%). Mortality of ICU treated patients was 19%. Three survivors underwent lower limb amputations for gangrene. Only 25% of the patients were immune-compromised, but alcohol abuse was common (69%). All patients had a contact with dogs, but only 37% had a history of a dog-bite.

CONCLUSION: Capnocytophaga canimorsus infection may present with severe sepsis or septic shock with organ dysfunction, most frequently coagulopathy and acute kidney injury. Previously recognized risk factors are not always present. A dog in a household may be a sufficient exposure for developing a severe form of the disease. The possibility of C. canimorsus infection should be considered in patients with any contact with dogs, even in immunocompetent patients.