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Rapid diagnosis of Capnocytophaga canimorsus septic shock in an immunocompetent individual using real-time Nanopore sequencing: a case report.
- Source :
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BMC infectious diseases [BMC Infect Dis] 2019 Jul 24; Vol. 19 (1), pp. 660. Date of Electronic Publication: 2019 Jul 24. - Publication Year :
- 2019
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Abstract
- Background: Rapid diagnosis and appropriate treatment is imperative in bacterial sepsis due increasing risk of mortality with every hour without appropriate antibiotic therapy. Atypical infections with fastidious organisms may take more than 4 days to diagnose leading to calls for improved methods for rapidly diagnosing sepsis. Capnocytophaga canimorsus is a slow-growing, fastidious gram-negative bacillus which is a common commensal within the mouths of dogs, but rarely cause infections in humans. C. canimorsus sepsis risk factors include immunosuppression, alcoholism and elderly age. Here we report on the application of emerging nanopore sequencing methods to rapidly diagnose an atypical case of C. canimorsus septic shock.<br />Case Presentation: A 62 year-old female patient was admitted to an intensive care unit with septic shock and multi-organ failure six days after a reported dog bite. Blood cultures were unable to detect a pathogen after 3 days despite observed intracellular bacilli on blood smears. Real-time nanopore sequencing was subsequently employed on whole blood to detect Capnocytophaga canimorsus in 19 h. The patient was not immunocompromised and did not have any other known risk factors. Whole-genome sequencing of clinical sample and of the offending dog's oral swabs showed near-identical C. canimorsus genomes. The patient responded to antibiotic treatment and was discharged from hospital 31 days after admission.<br />Conclusions: Use of real-time nanopore sequencing reduced the time-to-diagnosis of Capnocytophaga canimorsus in this case from 6.25 days to 19 h. Capnocytophaga canimorsus should be considered in cases of suspected sepsis involving cat or dog contact, irrespective of the patient's known risk factors.
- Subjects :
- Animals
Anti-Bacterial Agents therapeutic use
Capnocytophaga drug effects
Capnocytophaga genetics
Cats
Dogs
Female
Gram-Negative Bacterial Infections diagnosis
Gram-Negative Bacterial Infections immunology
Gram-Negative Bacterial Infections microbiology
Humans
Immunocompromised Host
Middle Aged
Nanopores
Sequence Analysis, DNA
Shock, Septic immunology
Shock, Septic microbiology
Bites and Stings complications
Capnocytophaga isolation & purification
Shock, Septic diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2334
- Volume :
- 19
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 31340776
- Full Text :
- https://doi.org/10.1186/s12879-019-4173-2