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Case Reports in Critical Care
Volume 2018, Article ID 7090268, 3 pages
https://doi.org/10.1155/2018/7090268
Case Report

Purpura Fulminans and Septic Shock due to Capnocytophaga Canimorsus after Dog Bite: A Case Report and Review of the Literature

1Intensive Care Medicine, University Hospital of Modena, Modena, Italy
2Laboratory of Microbiology, University Hospital of Modena, Modena, Italy

Correspondence should be addressed to Emanuela Biagioni; moc.liamg@inoigaib.aleuname

Received 30 March 2018; Revised 2 July 2018; Accepted 16 July 2018; Published 26 August 2018

Academic Editor: Mehmet Doganay

Copyright © 2018 Elena Mantovani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Primary infection by Capnocytophaga canimorsus after dog bite is rare but may be difficult to identify and rapidly lethal. We describe a case of fatal septic shock with fulminant purpura occurred in a patient without specific risk factor two days after an irrelevant dog bite. The patient was brought to hospital because of altered mental status, fever, and abdominal pain. In a few hours patient became hypoxic and cyanotic. The patient became extremely hypotensive with shock refractory to an aggressive fluid resuscitation (40 ml/kg crystalloids). She received vasoactive drugs, antibiotic therapy, and blood purification treatment, but cardiac arrest unresponsive to resuscitation maneuvers occurred. Case description and literature review demonstrated that, also in patients without specific risk factors, signs of infection after dog bite should be never underestimated and should be treated with a prompt antibiotic therapy initiation even before occurrence of organ dysfunction.