P36 | A case of sepsis caused by Capnocytophaga canimorsus infection complicated by meningitis in a young male splenectomized because affected by thalassemia major
N. Capoluongo1, I. Di Filippo1, G. Di Flumeri1, R. Signoriello1, G. Minei1, M. Bernardo2, R. De Rosa3, A. Perrella1 | 1UOC of Emerging and Highly Contagious Infectious Diseases Cotugno Hospital, Naples, 2UOC Clinic Pathology Cotugno Hospital, Naples, 3UOC Intensive Care Unit Cotugno Hospital, Naples, Italy
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Premises: Capnocytophaga canimorsus is a gram-negative bacteria presented in the oral cavity of dogs and cats. Asplenia, cirrhosis and alcohol abuse are risck factors for several infections in human people.
Description of the Case report: A 50-year-old man is hospitalizated at the Intensive Care Unit of the Cotugno Hospital in Naples due to respiratory failure on mechanical ventilation due to meningitis with cloudy liquor. The patient was splenectomized for thalassemia major, suffering from HCV-related cirrhosis, diabetes mellitus, ideomotor slowing (previous EEG).Glycorrhachia is 2 mg/dl, protidorrachia 421 mg/dl, 1739 cells of which 92.5% are polymorphonuclear. In the blood there is an alteration of CRP and PCT with an increase in neutrophils and lactates. After infectious disease consultation, therapy begins with meropenem 2 g every 8 hours, linezolid 600 mg every 12 hours, while waiting for the culture examination of the CSF and blood cultures. C. canimorsus is isolated from the blood culture for which therapy begins with ceftriaxone 2 g every 12 hours with regression of blood inflammation indices and remission of clinical symptoms, so he was transferred after 10 days to the division of Emerging and Highly Contagious Infectious Diseases. The patient was bitten by a dog 5 days before hospitalization and did not take antibiotic prophylaxis.
Conclusions: We describe a case of sepsis and purulent meningitis caused by C. canimorsus in a patient affected by cirrhosis and asplenia. It is most important to isolate the bacteria for a specific antibiotic therapy.
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