Capnocytophagia Sepsis and Spontaneous Splenic Rupture after a Minor Dog Bite

Abstract

Background: Spontaneous splenic rupture in critically ill patients without prior identified trauma or underlying splenic pathology is an uncommon event with multiple predisposing factors, including infectious etiologies. Case Presentation: We present the case of a 62-year-old female with history of mild chronic obstructive pulmonary disease and no prior known immunodeficiency who developed severe sepsis with multi-system organ failure two days after a mild dog bite on her wrist, with blood cultures positive for Capnocytophagia spp. She required anti-coagulation with heparin for disseminated intravascular coagulopathy (DIC) leading to deep vein thrombosis. Although she demonstrated resolution of sepsis, on hospital day 19 the patient experienced new onset of left upper quadrant pain; workup demonstrated spontaneous splenic rupture that required emergent splenectomy. She did well thereafter and continues to progress through inpatient rehabilitation from her sepsis. Conclusion(s): Capnocytophagia sepsis, although rare, progresses quickly to multi-system organ failure. Rapid identification of spontaneous splenic rupture may be challenging in these patients given the spectrum of their other physiologic abnormalities but is essential for appropriate surgical therapy.Copyright © 2016 Anthony R. Cyr et al.