Ahmad Ahsen Shin Kang Jack Lee Jose Sanchez Fadi Albahra Stephen Chabot Tariq Zain Ranjit Nair
HCA Healthcare
04-28-2023
Here we present a unique case of a 38-year-old Hispanic male with a history of alcohol abuse and multiple sexual partners, who presented with fulminant sepsis with shock, multiorgan failure, and lived..
Here we present a unique case of a 38-year-old Hispanic male with a history of alcohol abuse and multiple sexual partners, who presented with fulminant sepsis with shock, multiorgan failure, and livedo racemosa after a dog bite a week prior. Patient was intubated on arrival and started on vasopressors and antibiotics. He later developed gangrene of all of extremities, due to the severity of hypoperfusion and disseminated intravascular coagulation (DIC). Eventually, the patient’s clinical status improved, and he was transferred out of the intensive care unit (ICU). Peripheral blood smear showed gram-negative intracellular rods. Blood cultures tested positive for gram-negative rods one day after collection and later speciated to Capnocytophaga Canimorsus. One should have a high index of suspicion of Capnocytophaga if a patient presents with septic shock, has a history of dog bite, has a rash consistent with livedo racemosa, and slow-growing gram-negative intracellular rods on peripheral blood smear. Treatment should include meropenem and clindamycin. Adjunctive treatment with intravenous immunoglobulin is another consideration.