Warning: This article contains a graphic image of the patient's arm.
A healthy 63-year-old man recently died from septic shock with multi-organ failure after being licked by his pet dog, a new case study has detailed. He had contracted an infection usually caused by being bitten, which tends to only kill people with compromised immune systems, alcoholics, or those who have had their spleen surgically removed.
The man from Germany began to feel unwell when he experienced flu-like symptoms, such as fever and shortness of breath. However, on the third day of feeling sick, he developed purplish spots on his face caused by broken blood vessels under his skin and pain in his lower extremities, so he headed to the doctor. On examination, medics also noticed bleeding under the skin of his legs.
The man had not been abroad or hospitalized recently. Doctors suspected that he might have meningitis, but he was lacking some characteristic symptoms like a headache and stiff neck, so they investigated further. Blood tests revealed a low platelet count, low white blood cell count, and signs of sepsis, so he was transferred to the Intensive Care Unit. He also had liver and kidney problems, and was unable to urinate.
He was diagnosed with sepsis and purpura fulminans (potentially fatal blood spots caused by coagulation of blood in little vessels under the skin). Although a CT scan did not suggest an infection, doctors administered antibiotics to cover various infections, but his condition kept on deteriorating. His heart stopped, but he was successfully resuscitated and intubated, with doctors mechanically controlling his breathing. He also had severely low blood pressure.
On day four, the culprit was identified. The man was infected with Capnocytophaga canimorsus, a bacterium commonly found in the mouths of cats and dogs. Despite being given various antibiotics, the man died 16 days after he was first treated. The case is described in the European Journal of Case Reports in Internal Medicine.
The authors point out that this is an incredibly rare occurrence, noting that the infection has almost always been reported in immunodeficient people, with a quarter of people infected dying. They add that severe infections without actually being bitten by an animal are extremely rare.
Still, they write that “pet owners with flu-like symptoms should urgently seek medical advice when their symptoms exceed those of a simple viral infection,” such as severe breathing issues or bleeding under the skin. Meanwhile, doctors confronted with patients with these symptoms should immediately investigate the possibility of contact with cats and dogs and begin antibiotic treatment, even before a conclusive diagnosis is made.