Bizarre patient: his skin rots after being licked by his dog

At the hospital in Bremen, Germany, a 63-year-old man presents to the emergency room. For three days he has been suffering from symptoms flu and breathing difficulties. But what made him decide to come for a consultation was the appearance of a multitude of small purplish-red spots on his face – a facial petechiae in medical jargon – and abnormal pain in his right leg and in the extremities of his his body. He had no noticeable illness with these symptoms. He spent quiet days with his doghis only pet, who often licked his face.

A rapid bacterial infection transmitted by a dog

The doctors carry out a complete check-up which confirms the severity of his condition: 39°C from feverhypoxia, anemiaa thrombocytopenia and kidney damage. the diagnostic falls as the patient is transferred to the intensive care unit. He suffers from a purpura fulminans, the most severe form of sepsis. The bacterium at the origin of this infection generalized is not yet identified, but there is urgency, the patient must be treated as soon as possible. He receives an empirical cocktail of several effective antibiotics against the bacterial strains responsible for this kind of symptom.

Less than two days after his admission, his kidneys and his liver let go. He makes a cardiac arrest but the doctors manage to resuscitate him. In the meantime, the hospital’s microbiology laboratory delivers its results: the man is infected with Capnocytophaga canimorsusa commensal bacterium in the saliva dogs and cats. With this information, the doctors can adapt his antibiotic therapy, but nothing helps, the disease is too advanced to stop it. Ten days after his hospitalization, his skin literally begins to rot, his fingers and toes become necrotic and turn black. His fever rises to 41°C and scans show failure of several vital organs. He died 16 days after his arrival.

This case, reported in theEuropean Journal of Case Reports in Internal Medicine, is exceptional. On very rare occasions the bacteria Capnocytophaga canimorsus can cause infections in humans. However, most cases appear after a bite or contact between the animal’s saliva and an open wound in immunocompromised people, alcoholics or with part of the liver removed. About three in ten people contract severe sepsis. The 63-year-old fails to meet any of his criteria; his dog only licked it and he was not immunocompromised. Should we stop our pets from licking us? Maybe not, but the doctors in charge of this case remind that dog and cat owners who experience more flu-like symptoms than usual after contact with their animal’s saliva should consult a doctor without delay. .