Baylor University Medical Center Proceedings April 2014, Volume 27, Number 2 | Page 65

Renal failure due to Capnocytophaga canimorsus generalized
Shwartzman reaction from a dog bite (DF-2 nephropathy)
Valerie Tan, MD, and John C. Schwartz, MD

We report a case of a 54-year-old man who developed gram-negative
sepsis with multiorgan failure and generalized Shwartzman reaction after
sustaining a dog bite. The causative organism was the fastidious gramnegative rod Capnocytophaga canimorsus, which is a commensal organism found in the oral flora of dogs and cats. More than 30 years after it
was first described and despite technological advances in identification
techniques, proper identification of this organism remains a challenge. In
light of the increase in pet ownership as well as the increase in the different immunocompromised populations of the 21st century, we decided to
revisit the case and reignite awareness of physicians caring for patients
with recent dog or cat bites presenting with fulminant sepsis.

Table 1. Admitting laboratory results
Day 1
White blood cells (K/uL)

Day 2

3.9

Neutrophils (%)

41

Bands (%)

43

Metamyelocytes (%)

3

Platelet count (K/uL)

115

Prothrombin time (seconds)

50

Partial thromboplastin time (seconds)

15

>200

C

CASE REPORT
A 54-year-old white man with previously good health was
admitted with septic shock. A dog had bitten his left thumb
3 days earlier. The wound was cleaned and nothing unusual
happened over the next 2 days. Fever, chills, and myalgias then
appeared. He was admitted through the emergency room with
dyspnea and changes in skin color.
His temperature was 103.4°F; blood pressure, 70/45 mm
Hg; respiratory &FR